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The peak-to-end of the T wave in the limb ECG leads reflects total spatial rather than transmural dispersion of ventricular repolarization in an anthopleurin-A model of prolonged QT interval.
MedLine Citation:
PMID:  22123313     Owner:  NLM     Status:  Publisher    
BACKGROUND: Previous studies showed that the interval between peak and end of the T wave (Tp-e) is a marker of transmural dispersion of ventricular repolarization. OBJECTIVE: We studied the relationship between a) the Tp-e on local pseudo transmural electrograms (pseudo transmural Tp-e) or limb leads of body surface ECG (surface Tp-e) and b) the intracardiac left ventricular (LV) repolarization during a drug-induced QT interval prolongation. METHODS: Using open-chested canine intact hearts treated by anthopleurin-A, transmural LV electrograms were recorded via needle electrodes placed in the baso-anterior, mid-anterior, apico-anterior, baso-lateral, mid-lateral, and apico-lateral LV wall. Recovery time (RT) was calculated as an index of local repolarization at each transmural unipolar electrode. RESULTS: This model showed slower heart rate dependent heterogeneous distribution of ventricular repolarization both along the basal to apical axis and along the transmural axis. RT was longer at the LV apex than at the base, and longer in the lateral than in the anterior wall during the slower heart rate. A high correlation was found between surface Tp-e and total LV dispersion. In contrast, pseudo transmural Tp-e correlated with transmural RT dispersion. The shortest RT in the heart roughly corresponded to the peak, as did the longest RT with the end of the T wave on the surface ECG. CONCLUSION: During drug-induced QT interval prolongation with a large apico-basal and anterior-lateral dispersion of ventricular repolarization, the Tp-e interval in the limb leads expresses spatial (total) distribution of repolarization in the whole LV.
Daisuke Izumi; Masaomi Chinushi; Kenichi Iijima; Hiroshi Furushima; Yukio Hosaka; Kanae Hasegawa; Yoshifusa Aizawa
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-25
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Inc.
First Department of Internal Medicine, Niigata University School of Medicine, JAPAN.
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