Document Detail


Unstable QT interval dynamics precedes ventricular tachycardia onset in patients with acute myocardial infarction: a novel approach to detect instability in QT interval dynamics from clinical ECG.
MedLine Citation:
PMID:  21841208     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Instability in ventricular repolarization in the presence of premature activations (PA) plays an important role in arrhythmogenesis. However, such instability cannot be detected clinically. This study developed a methodology for detecting QT interval (QTI) dynamics instability from the ECG and explored the contribution of PA and QTI instability to ventricular tachycardia (VT) onset.
METHODS AND RESULTS: To examine the contribution of PAs and QTI instability to VT onset, ECGs of 24 patients with acute myocardial infarction, 12 of whom had sustained VT (VT) and 12 nonsustained VT (NSVT), were used. From each patient ECG, 2 10-minute-long ECG recordings were extracted, 1 right before VT onset (onset epoch) and 1 at least 1 hour before it (control epoch). To ascertain how PA affects QTI dynamics stability, pseudo-ECGs were calculated from an MRI-based human ventricular model. Clinical and pseudo-ECGs were subdivided into 1-minute recordings (minECGs). QTI dynamics stability of each minECG was assessed with a novel approach. Frequency of PAs (f(PA)) and the number of minECGs with unstable QTI dynamics (N(us)) were determined for each patient. In the VT group, f(PA) and N(us) of the onset epoch were larger than in control. Positive regression relationships between f(PA) and N(us) were identified in both groups. The simulations showed that both f(PA) and the PA degree of prematurity contribute to QTI dynamics instability.
CONCLUSIONS: Increased PA frequency and QTI dynamics instability precede VT onset in patients with acute myocardial infarction, as determined by novel methodology for detecting instability in QTI dynamics from clinical ECGs.
Authors:
Xiaozhong Chen; Yuxuan Hu; Barry J Fetics; Ronald D Berger; Natalia A Trayanova
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-08-14
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  4     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-28     Completed Date:  2012-02-16     Revised Date:  2014-09-19    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  858-66     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Algorithms
Analysis of Variance
Atrial Premature Complexes / diagnosis*,  etiology,  physiopathology
Computer Simulation
Electrocardiography*
Female
Heart Conduction System / physiopathology*
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Models, Cardiovascular
Myocardial Infarction / complications*,  diagnosis,  physiopathology
Predictive Value of Tests
Risk Assessment
Risk Factors
Signal Processing, Computer-Assisted
Tachycardia, Ventricular / diagnosis*,  etiology,  physiopathology
Time Factors
Ventricular Premature Complexes / diagnosis*,  etiology,  physiopathology
Grant Support
ID/Acronym/Agency:
R01 HL063195/HL/NHLBI NIH HHS; R01 HL063195-09/HL/NHLBI NIH HHS; R01 HL103428/HL/NHLBI NIH HHS; R01 HL103428-01A1/HL/NHLBI NIH HHS; R01HL082729/HL/NHLBI NIH HHS
Comments/Corrections

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


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