Optimal method of measuring the T-peak to T-end interval for risk stratification in primary prevention
| Autor: | Joel Q. Xue, Sammy Khatib, Glenn M. Polin, Todd M. Rosenthal, Freddy M Abi Samra, Daniel P. Morin, Daniel Masvidal, Paul A. Rogers, Michael L. Bernard |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Electric Countershock Action Potentials 030204 cardiovascular system & hematology Risk Assessment Ventricular Function Left Standard deviation Electrocardiography Ventricular Dysfunction Left 03 medical and health sciences 0302 clinical medicine Heart Rate Predictive Value of Tests Risk Factors Physiology (medical) Internal medicine Primary prevention Heart rate medicine Humans 030212 general & internal medicine Lead (electronics) Aged Aged 80 and over Ejection fraction business.industry Surrogate endpoint Stroke Volume Middle Aged Defibrillators Implantable Primary Prevention Death Sudden Cardiac Automated algorithm Ventricular Fibrillation Risk stratification Tachycardia Ventricular Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | EP Europace. 20:698-705 |
| ISSN: | 1532-2092 1099-5129 |
| Popis: | Several published investigations demonstrated that a longer T-peak to T-end interval (Tpe) implies increased risk for ventricular tachyarrhythmia (VT/VF) and mortality. Tpe has been measured using diverse methods. We aimed to determine the optimal Tpe measurement method for screening purposes.We evaluated 305 patients with LVEF ≤ 35% and an implantable cardioverter-defibrillator implanted for primary prevention. Tpe was measured using seven different methods described in the literature, including six manual methods and the automated algorithm '12SL', and was corrected for heart rate. Endpoints were VT/VF and death. To account for differences in the magnitude of Tpe measurements, results are expressed in standard deviation (SD) increments. We evaluated the clinical utility of each measurement method based on predictive ability, fraction of immeasurable tracings, and intra- and interobserver correlation.Over 31 ± 23 months, 82 (27%) patients had VT/VF, and over 49 ± 21 months, 91 (30%) died. Several rate-corrected Tpe measurement methods predicted VT/VF (HR per SD 1.20-1.34; all P0.05), and nearly all methods (both corrected and uncorrected) predicted death (HR per SD 1.19-1.35; all P0.05). Optimal predictive ability, readability, and correlation were found in the automated 12SL method and the manual tangent method in lead V2.For the prediction of VT/VF, the utility of Tpe depends upon the measurement method, but for the prediction of mortality, most published Tpe measurement methods are similarly predictive. Heart rate correction improves predictive ability. The automated 12SL method performs as well as any manual measurement, and among manual methods, lead V2 is most useful. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|