Relationships between the T-peak to T-end interval, ventricular tachyarrhythmia, and death in left ventricular systolic dysfunction

Morin, Daniel P., Saad, Marc N., Shams, Omar F., Owen, J. Sam, Xue, Joel Q., Abi-Samra, Freddy M., Khatib, Sammy, Nelson-Twakor, Onajefe S. and Milani, Richard V. (2012) Relationships between the T-peak to T-end interval, ventricular tachyarrhythmia, and death in left ventricular systolic dysfunction. Europace, 14 8: 1172-1179. doi:10.1093/europace/eur426


Author Morin, Daniel P.
Saad, Marc N.
Shams, Omar F.
Owen, J. Sam
Xue, Joel Q.
Abi-Samra, Freddy M.
Khatib, Sammy
Nelson-Twakor, Onajefe S.
Milani, Richard V.
Title Relationships between the T-peak to T-end interval, ventricular tachyarrhythmia, and death in left ventricular systolic dysfunction
Journal name Europace   Check publisher's open access policy
ISSN 1099-5129
1532-2092
Publication date 2012-08
Sub-type Article (original research)
DOI 10.1093/europace/eur426
Open Access Status DOI
Volume 14
Issue 8
Start page 1172
End page 1179
Total pages 8
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Language eng
Formatted abstract
Aims The interval between the T-wave's peak and end (Tpe), an electrocardiographic (ECG) index of ventricular repolarization, has been proposed as an indicator of arrhythmic risk. We aimed to clarify the clinical usefulness of Tpe for risk stratification.
Methods and results We evaluated 327 patients with left ventricular ejection fraction (LVEF) ≤35% (75% male, LVEF 23 ± 7%). All patients had an implanted implantable cardioverter-defibrillator (ICD). Clinical data and ECGs were analysed at baseline. Prospective follow-up for the endpoints of appropriate ICD therapy and mortality was conducted via periodic device interrogation, chart review, and the Social Security Death Index. During device clinic follow-up of 17 ± 12 months, 59 (18%) patients had appropriate ICD therapy, and during mortality follow-up of 30 ± 13 months, 67 (21%) patients died. A longer Tpec predicted appropriate ICD therapy, death, and the combination of appropriate ICD therapy or death (P< 0.01 for each endpoint). On multivariable analysis correcting for other univariable predictors, Tpec remained predictive of ICD therapy [hazard ratio (HR) per 10 ms increase: 1.16, P= 0.02], all-cause mortality (HR per 10 ms: 1.14, P= 0.03), and the composite endpoint of ICD therapy or death (HR per 10 ms: 1.16, P< 0.01).
Conclusions In patients with left ventricular systolic dysfunction and an implanted ICD, Tpec independently predicts both ventricular tachyarrhythmia and overall mortality.

Keyword Risk stratification
Ventricular tachyarrhythmia
Electrocardiography
Death
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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