Benign vs. malignant inferolateral early repolarization: Focus on the T wave.
Heart Rhythm
; 13(4): 894-902, 2016 Apr.
Article
em En
| MEDLINE
| ID: mdl-26592849
ABSTRACT
BACKGROUND:
Inferolateral early repolarization (ER) is highly prevalent and is associated with idiopathic ventricular fibrillation (VF).OBJECTIVE:
The purpose of this study was to evaluate the potential role of T-wave parameters to differentiate between malignant and benign ER.METHODS:
We compared the ECGs of patients with ER and VF (n = 92) with control subjects with asymptomatic ER (n = 247). We assessed J-wave amplitude, QTc interval, T-wave/R-wave (T/R) ratio in leads II and V5, and presence of low-amplitude T waves (T-wave amplitude <0.1 mV and <10% of R-wave amplitude in lead I, II, or V4-V6).RESULTS:
Compared to controls, the VF group had longer QTc intervals (388 ms vs. 377 ms, P = .001), higher J-wave amplitudes (0.23 mV vs. 0.17 mV, P <.001), higher prevalence of low-amplitude T waves (29% vs. 3%, P <.001), and lower T/R ratio (0.18 vs. 0.30, P <.001). Logistic regression analysis demonstrated that QTc interval (odds ratio [OR] per 10 ms 1.15, 95% confidence interval [CI} 1.02-1.30), maximal J-wave amplitude (OR per 0.1 mV 1.68, 95% CI 1.23-2.31), lower T/R ratio (OR per 0.1 unit 0.62, 95% CI 0.47-0.81), presence of low-amplitude T waves (OR 3.53, 95% CI 1.26-9.88). and presence of J waves in the inferior leads (OR 2.58, 95% CI 1.18-5.65) were associated with malignant ER.CONCLUSION:
Patients with malignant ER have a higher prevalence of low-amplitude T waves, lower T/R ratio (lead II or V5), and longer QTc interval. The combination of these parameters with J-wave amplitude and distribution of J waves may allow for improved identification of malignant ER.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Fibrilação Ventricular
/
Eletrocardiografia
/
Sistema de Condução Cardíaco
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article