Benign vs. malignant inferolateral early repolarization: Focus on the T wave
Language English Country United States Media print-electronic
Document type Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
PubMed
26592849
DOI
10.1016/j.hrthm.2015.11.020
PII: S1547-5271(15)01427-7
Knihovny.cz E-resources
- Keywords
- Early repolarization, Electrocardiogram, J wave, QT interval, Ventricular fibrillation,
- MeSH
- Adult MeSH
- Electrocardiography * MeSH
- Ventricular Fibrillation diagnosis epidemiology physiopathology MeSH
- Middle Aged MeSH
- Humans MeSH
- Survival Rate trends MeSH
- Follow-Up Studies MeSH
- Prevalence MeSH
- Heart Conduction System physiopathology MeSH
- Retrospective Studies MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Randomized Controlled Trial MeSH
- Geographicals
- Europe epidemiology MeSH
BACKGROUND: Inferolateral early repolarization (ER) is highly prevalent and is associated with idiopathic ventricular fibrillation (VF). OBJECTIVE: The purpose of this study was to evaluate the potential role of T-wave parameters to differentiate between malignant and benign ER. METHODS: We compared the ECGs of patients with ER and VF (n = 92) with control subjects with asymptomatic ER (n = 247). We assessed J-wave amplitude, QTc interval, T-wave/R-wave (T/R) ratio in leads II and V5, and presence of low-amplitude T waves (T-wave amplitude <0.1 mV and <10% of R-wave amplitude in lead I, II, or V4-V6). RESULTS: Compared to controls, the VF group had longer QTc intervals (388 ms vs. 377 ms, P = .001), higher J-wave amplitudes (0.23 mV vs. 0.17 mV, P <.001), higher prevalence of low-amplitude T waves (29% vs. 3%, P <.001), and lower T/R ratio (0.18 vs. 0.30, P <.001). Logistic regression analysis demonstrated that QTc interval (odds ratio [OR] per 10 ms: 1.15, 95% confidence interval [CI} 1.02-1.30), maximal J-wave amplitude (OR per 0.1 mV: 1.68, 95% CI 1.23-2.31), lower T/R ratio (OR per 0.1 unit: 0.62, 95% CI 0.47-0.81), presence of low-amplitude T waves (OR 3.53, 95% CI 1.26-9.88). and presence of J waves in the inferior leads (OR 2.58, 95% CI 1.18-5.65) were associated with malignant ER. CONCLUSION: Patients with malignant ER have a higher prevalence of low-amplitude T waves, lower T/R ratio (lead II or V5), and longer QTc interval. The combination of these parameters with J-wave amplitude and distribution of J waves may allow for improved identification of malignant ER.
Centre Hospitalier Universitaire de Strasbourg Strasbourg France
Centre Hospitalier Universitaire de Toulouse Toulouse France
Department of Cardiology Toulouse University School of Medicine Toulouse France
Deutsches Herzzentrum München München Germany
Institute for Clinical and Experimental Medicine Prague Czech Republic
L׳institut du thorax service de cardiologie du CHU de Nantes Nantes France
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