Document Detail

Dispersion of ventricular repolarization and arrhythmic cardiac death in coronary artery disease.
MedLine Citation:
PMID:  8074036     Owner:  NLM     Status:  MEDLINE    
In a recent prospective study of myocardial ischemia, arrhythmic cardiac death occurred in 17 of 936 patients (2%) during a 2-year follow-up after acute myocardial infarction or unstable angina. Dispersion of ventricular repolarization was evaluated on the 12-lead electrocardiogram at enrollment in 17 patients who subsequently died of cardiac arrhythmia and in 51 matched survivors. The aim of this study was to evaluate the relation between various measurements of dispersion of repolarization and subsequent arrhythmic cardiac death, and to determine if dispersion of repolarization makes an independent contribution to the risk of arrhythmic cardiac death. Ventricular depolarization quantitated in terms of mean QRS (QRS-m) duration, and ventricular repolarization quantitated in terms of mean (m), maximal-minimal dispersion (d), standard deviation (s), and coefficient of variation (cv) of QT and JT intervals, were determined. Univariate analyses revealed that 2 standard electrocardiographic parameters, QRS-m and QT-m, and 3 dispersion variables, JT-d, JT-s, and JTc-d, were associated with arrhythmic cardiac death (p < 0.01). Multivariate analyses revealed that the combination of the dispersion parameter (JT-d, JT-s, or JTc-d) and QRS-m made an independent contribution to the risk of arrhythmic cardiac death. The findings highlight the importance of both delayed depolarization and heterogenous repolarization as risk factors for arrhythmic cardiac death. Thus, increased dispersion of repolarization is associated with an elevated likelihood of arrhythmic cardiac death. Prolonged QRS duration and increased dispersion of repolarization make independent contributions to the risk of arrhythmic cardiac death in patients with coronary artery disease.
W Zareba; A J Moss; S le Cessie
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  74     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1994 Sep 
Date Detail:
Created Date:  1994-09-28     Completed Date:  1994-09-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  550-3     Citation Subset:  AIM; IM    
Department of Preventive and Community Medicine, University of Rochester School of Medicine and Dentistry, New York.
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MeSH Terms
Analysis of Variance
Angina, Unstable / complications,  physiopathology
Death, Sudden, Cardiac / etiology*
Heart Conduction System / physiology
Heart Ventricles / physiopathology*
Middle Aged
Myocardial Infarction / complications,  physiopathology
Myocardial Ischemia / complications*,  physiopathology*
Tachycardia, Ventricular / complications*,  etiology,  physiopathology*

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