Analysis of ECG Measures of Cardiac Repolarization in Relation to Arrhythmic Events in an Implantable Cardioverter Defibrillator Population

作者：Shi Bijia^*; Harding Scott; Larsen Peter

来源：Annals of Noninvasive Electrocardiology, 2017, 22(2): e12390.

DOI：10.1111/anec.12390

• noninvasive techniques - electrocardiography
• implantable devices - ventricular tachycardia/fibrillation
• cardiac repolarization

Background: ECG-derived measures of cardiac repolarization may have utility in risk prediction of future ventricular arrhythmia, and a range of different measures have been proposed. We compared time-based, vectorcardiographic, and singular value decomposition (SVD) derived measures of repolarization to determine which was most predictive of appropriate therapy in an ICD population.
Methods: We examined the independent prognostic value of a range of repolarization measures derived from 60 second 12-lead ECG recordings in 150 patients receiving new ICD implants in relation to the occurrence of appropriate therapy during follow-up.
Results: Over an average follow-up of 2.15 0.87 years, male gender, presence of premature ventricular complex (PVC), relative T wave residuum (TWR-rel, measures regional repolarization heterogeneity), and TCRT (the total cosine R-to-T, describes the global angle between repolarization and depolarization wavefronts) were the only independent predictors of appropriate therapy. With every 0.01% increase in TWR-rel, there was 2% increased risk of appropriate therapy (HR = 1.02, 95% CI 1.006-1.034, P < 0.001). With every 1 degrees decrease in TCRT, there was an increase in arrhythmic risk of 0.9% (HR 1.009, 95% CI 1.003-1.015, P = 0.003).
Conclusions: The use of advanced analytic ECG techniques to derive measures of repolarization abnormality might shave utility in risk stratification in an ICD population.

• 出版日期2017-3