Document Detail


Clinical investigation: Utility of left ventricular end diastolic diameter in the prediction of susceptibility to ventricular tachyarrhythmias.
MedLine Citation:
PMID:  17188377     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Prior studies have shown the utility of using both QRS duration and QT dispersion (QTd) as predictors of risk for ventricular tachyarrhythmias (VA). Lengthening of the QRS duration represents dyssynchrony of regional myocardial wall contraction, and increased QTd similarly represents variations in myocardial repolarization. We sought to examine the left ventricular end diastolic diameter (LVEDD) as a predictor of VA susceptibility. METHODS: Eighty-eight patients referred for electrophysiologic (EP) studies were evaluated. EP testing was performed using a standard protocol of up to three extrastimuli. QTd and QRS duration analyses were performed in a blinded manner. Values were defined as abnormal if QRS duration>120 ms, QTd>60 ms, and LVEDD>6 cm. RESULTS: Of 88 patients (65 males; 23 females; mean age 67+/-15 years), 33 were inducible by EP testing. Patients with either increased QRS duration or QTd are shown to be at greater risk for VA inducibility. LVEDD is a strong predictor of inducibility for VA (p<0.02 between inducible and non-inducible patients). LVEDD in combination with QRS duration and QTd, further strengthens predictability for VA (p<0.03 for QRS duration and p<0.02 for QTd) with a trend towards inducibility as each value increases. Combination of the three parameters of QRS duration, QTd, and LVEDD was 91% sensitive for the identification of those patients inducible for VA. CONCLUSION: The LVEDD is an echocardiographic value that strongly predicts VA inducibility, and when combined with QRS duration and QTd, identifies patients at higher risk for these tachyarrhythmias.
Authors:
Amgad N Makaryus; John N Catanzaro; Craig D Hametz; Ram L Jadonath
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Publication Detail:
Type:  Journal Article     Date:  2006-12-22
Journal Detail:
Title:  International journal of cardiology     Volume:  120     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-07-23     Completed Date:  2007-10-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  399-403     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Section of Electrophysiology, North Shore University Hospital, Manhasset, New York, United States.
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MeSH Terms
Descriptor/Qualifier:
Aged
Diastole / physiology*
Echocardiography
Electrophysiologic Techniques, Cardiac
Female
Humans
Male
Predictive Value of Tests
Risk Assessment
Sensitivity and Specificity
Stroke Volume / physiology
Tachycardia, Ventricular / physiopathology*
Ventricular Dysfunction, Left / physiopathology*,  ultrasonography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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