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Terminal T-wave inversion predicts reperfusion tachyarrhythmias in STEMI
KA. Sedova, MM. Demidova, JE. Azarov, J. Hejda, J. Carlson, OG. Bernikova, N. Arteyeva, D. Erlinge, PG. Platonov
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, práce podpořená grantem
- MeSH
- elektrokardiografie metody MeSH
- fibrilace komor etiologie MeSH
- infarkt myokardu přední stěny * MeSH
- infarkt myokardu s elevacemi ST úseků * komplikace diagnóza MeSH
- koronární angioplastika * MeSH
- lidé středního věku MeSH
- lidé MeSH
- reperfuze škodlivé účinky MeSH
- retrospektivní studie MeSH
- senioři MeSH
- tachykardie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
INTRODUCTION: A reliable electrocardiographic predictor of ventricular fibrillation (VF) in patients with ST elevation myocardial infarction (STEMI) is lacking so far. Previous experimental/simulation study suggested a terminal T-wave inversion (TTWI) in ischemia-related ECG leads corresponding to anterior infarct localization as an independent predictor of reperfusion VF (rVF). This T-wave characteristic has never been tested as a rVF predictor in clinical settings. The aim of this study was to test if terminal T-wave inversion (TTWI) at admission ECG (before reperfusion) can serve as a predictor of ventricular fibrillation during reperfusion (rVF) in patients with anterior STEMI undergoing primary PCI. METHODS AND RESULTS: Study population included consecutive patients with anterior infarct localization admitted for primary PCI (n = 181, age 65 [57; 76] years, 66% male). Of those, 14 patients had rVF (rVF group, age 59 [47; 76] years, 64% male) and patients without rVF comprised the No-rVF group (n = 167, age 65 [57; 76] years, 66% male). Association of TTWI with rVF was analyzed using logistic regression analysis adjusted for relevant clinical and electrocardiographic covariates. The prevalence of TTWI in rVF group was 62% comparing to 23% in the No-rVF group, p = 0.005. TTWI was associated with increased risk of rVF (OR 5.51; 95% CI 1.70-17.89; p = 0.004) and remained a significant predictor after adjustment for age, gender, history of MI prior to index admission, VF before reperfusion, Tpeak-Tend, maximal ST elevation, and QRS duration (OR 23.49; 95% CI 3.14-175.91; p = 0.002). CONCLUSIONS: The terminal T-wave inversion in anterior leads before PCI independently predicted rVF in patients with anterior MI thus confirming the previous experimental/simulation findings.
5 A Almazov National Medical Research Center Saint Petersburg Russia
Arrhythmia Clinic Skåne University Hospital 22185 Lund Sweden
Department of Cardiology Clinical Sciences Lund University Lund Sweden
Citace poskytuje Crossref.org
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- $a Sedova, Ksenia A $u Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic. Electronic address: ksenia.sedova@fbmi.cvut.cz
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- $a Terminal T-wave inversion predicts reperfusion tachyarrhythmias in STEMI / $c KA. Sedova, MM. Demidova, JE. Azarov, J. Hejda, J. Carlson, OG. Bernikova, N. Arteyeva, D. Erlinge, PG. Platonov
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- $a INTRODUCTION: A reliable electrocardiographic predictor of ventricular fibrillation (VF) in patients with ST elevation myocardial infarction (STEMI) is lacking so far. Previous experimental/simulation study suggested a terminal T-wave inversion (TTWI) in ischemia-related ECG leads corresponding to anterior infarct localization as an independent predictor of reperfusion VF (rVF). This T-wave characteristic has never been tested as a rVF predictor in clinical settings. The aim of this study was to test if terminal T-wave inversion (TTWI) at admission ECG (before reperfusion) can serve as a predictor of ventricular fibrillation during reperfusion (rVF) in patients with anterior STEMI undergoing primary PCI. METHODS AND RESULTS: Study population included consecutive patients with anterior infarct localization admitted for primary PCI (n = 181, age 65 [57; 76] years, 66% male). Of those, 14 patients had rVF (rVF group, age 59 [47; 76] years, 64% male) and patients without rVF comprised the No-rVF group (n = 167, age 65 [57; 76] years, 66% male). Association of TTWI with rVF was analyzed using logistic regression analysis adjusted for relevant clinical and electrocardiographic covariates. The prevalence of TTWI in rVF group was 62% comparing to 23% in the No-rVF group, p = 0.005. TTWI was associated with increased risk of rVF (OR 5.51; 95% CI 1.70-17.89; p = 0.004) and remained a significant predictor after adjustment for age, gender, history of MI prior to index admission, VF before reperfusion, Tpeak-Tend, maximal ST elevation, and QRS duration (OR 23.49; 95% CI 3.14-175.91; p = 0.002). CONCLUSIONS: The terminal T-wave inversion in anterior leads before PCI independently predicted rVF in patients with anterior MI thus confirming the previous experimental/simulation findings.
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- $a Demidova, Marina M $u Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden; V.A. Almazov National Medical Research Center, Saint Petersburg, Russia
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- $a Azarov, Jan E $u Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden; Department of Cardiac Physiology, Institute of Physiology, Komi Science Center, Ural Branch of Russian Academy of Sciences, Syktyvkar, Komi Republic, Russia
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- $a Hejda, Jan $u Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
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- $a Bernikova, Olesya G $u Department of Cardiac Physiology, Institute of Physiology, Komi Science Center, Ural Branch of Russian Academy of Sciences, Syktyvkar, Komi Republic, Russia
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- $a Arteyeva, Natalia $u Department of Cardiac Physiology, Institute of Physiology, Komi Science Center, Ural Branch of Russian Academy of Sciences, Syktyvkar, Komi Republic, Russia
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- $a Erlinge, David $u Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden
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- $a Platonov, Pyotr G $u Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden; Arrhythmia Clinic, Skåne University Hospital, 22185 Lund, Sweden
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