Multi‐lead vs single‐lead Tpeak‐Tend interval measurements for prediction of reperfusion ventricular tachyarrhythmias

IntroductionElectrocardiographic Tpeak‐Tend interval (Tp‐Te) is a promising marker for the prediction of ventricular tachycardia and/or ventricular fibrillation (VT/VF). The study was aimed to compare single‐lead vs multilead Tp‐Te variables as VT/VF predictors in experimental ischemia/reperfusion m...

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Published in:Journal of cardiovascular electrophysiology 2019-10, Vol.30 (10), p.2090-2097
Main Authors: Sedova, Ksenia, Galinyte, Viktorija, Arteyeva, Natalia, Hejda, Jan, Bernikova, Olesya, Kneppo, Peter, Azarov, Jan
Format: Article
Language:English
Subjects:
Computer simulation
Coronary artery
Electrocardiography
Fibrillation
Heart
Ischemia
Mathematical models
Myocardial ischemia
Regression analysis
Reperfusion
Tachycardia
Ventricle
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Summary:IntroductionElectrocardiographic Tpeak‐Tend interval (Tp‐Te) is a promising marker for the prediction of ventricular tachycardia and/or ventricular fibrillation (VT/VF). The study was aimed to compare single‐lead vs multilead Tp‐Te variables as VT/VF predictors in experimental ischemia/reperfusion model.Methods and ResultsComputer simulations were done using the ECGSIM model with an ischemic region set in anterior left ventricular apex. In 18 anesthetized cats, myocardial ischemia was induced by 30‐minute ligation of left anterior descending coronary artery followed by reperfusion. Body surface ECGs in limb leads and modified precordial leads were recorded. Tp‐Te was detected automatically in individual leads with a custom‐designed parametric algorithm. Tp‐Te dispersion and total Tp‐Te were calculated as a difference between the maximal and minimal value of individual Tp‐Te(s) and an interval between the earliest Tpeak and the latest Tend throughout all leads, respectively.Simulations showed that the increase of local, but not total, dispersion of repolarization characteristic for ischemic damage led to nonuniform shortening of T‐peak times across 12 standard leads, which in turn resulted in the increase of single‐lead Tp‐Te(s), total Tp‐Te and Tp‐Te dispersion. Animals experienced VT/VF showed increased Tp‐Te dispersion and total Tp‐Te during reperfusion. In univariate logistic regression analysis, only the Tp‐Te dispersion at the beginning of reperfusion was associated with the VT/VF incidence. According to ROC curve analysis, the optimal cut‐off value of the Tp‐Te dispersion was 17 ms (sensitivity 0.71, specificity 0.80).ConclusionsThe reperfusion VT/VFs were independently predicted by increased Tp‐Te dispersion, which suggests the importance of multi‐lead evaluation of Tp‐Te intervals.
ISSN:1045-3873
1540-8167
DOI:10.1111/jce.14105