Relationships between the T-peak to T-end interval, ventricular tachyarrhythmia, and death in left ventricular systolic dysfunction
Daniel P. Morin,Marc N. Saad,Omar F. Shams,J. Sam Owen,Joel Q. Xue,Freddy M. Abi-Samra,Sammy Khatib,Onajefe S. Nelson-Twakor,Richard V. Milani +8 more
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TLDR
In patients with left ventricular systolic dysfunction and an implanted ICD, Tpe(c) independently predicts both ventricular tachyarrhythmia and overall mortality.Abstract:
AimsThe interval between the T-wave's peak and end (Tpe), an electrocardiographic (ECG) index of ventricular repolarization, has been proposed as an indicator of arrhythmic risk. We aimed to clarify the clinical usefulness of Tpe for risk stratification. Methods and resultsWe evaluated 327 patients with left ventricular ejection fraction (LVEF) ≤35 (75 male, LVEF 23 ± 7). All patients had an implanted implantable cardioverter- defibrillator (ICD). Clinical data and ECGs were analysed at baseline. Prospective follow-up for the endpoints of appropriate ICD therapy and mortality was conducted via periodic device interrogation, chart review, and the Social Security Death Index. During device clinic follow-up of 17 ± 12 months, 59 (18) patients had appropriate ICD therapy, and during mortality follow-up of 30 ± 13 months, 67 (21) patients died. A longer Tpec predicted appropriate ICD therapy, death, and the combination of appropriate ICD therapy or death (P< 0.01 for each endpoint). On multivariable analysis correcting for other univariable predictors, Tpec remained predictive of ICD therapy [hazard ratio (HR) per 10 ms increase: 1.16, P=0.02], all-cause mortality (HR per 10 ms: 1.14, P=0.03), and the composite endpoint of ICD therapy or death (HR per 10 ms: 1.16, P< 0.01). ConclusionsIn patients with left ventricular systolic dysfunction and an implanted ICD, Tpec independently predicts both ventricular tachyarrhythmia and overall mortality.read more
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Journal Article
Cellular Basis for the Normal T Wave and the Electrocardiographic Manifestations of the Long-QT Syndrome
Gan-XinYan,CharlesAntzelevitch +1 more
TL;DR: The action potential duration (APD) of the longest M cells determine the QT interval and the Tpeak–Tend interval serves as an index of transmural dispersion of repolarization.
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The Tpeak − Tend interval as an electrocardiographic risk marker of arrhythmic and mortality outcomes: A systematic review and meta-analysis
Gary Tse,Gary Tse,Mengqi Gong,Wing Tak Wong,Stamatis Georgopoulos,Konstantinos P. Letsas,Vassilios S. Vassiliou,Vassilios S. Vassiliou,Yat Sun Chan,Bryan P. Yan,Sunny H. Wong,William K.K. Wu,Ana Ciobanu,Guangping Li,Jayaprakash Shenthar,Ardan M. Saguner,Sadeq Ali-Hasan-Al-Saegh,Aishwarya Bhardwaj,Abhishek C. Sawant,Paula J Whittaker,Yunlong Xia,Gan-Xin Yan,Gan-Xin Yan,Tong Liu +23 more
TL;DR: The Tpeak - Tend interval is a useful risk stratification tool in different diseases and in the general population.
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Ventricular repolarization markers for predicting malignant arrhythmias in clinical practice
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QRS fragmentation and the risk of sudden cardiac death in MADIT II.
Andrew Brenyo,M.P.H. Grzegorz Pietrasik M.D.,Alon Barsheshet,David T. Huang,Bronislava Polonsky,Scott Mcnitt,Arthur J. Moss,Wojciech Zareba +7 more
TL;DR: QRS Fragmentation and the Risk of Sudden Cardiac Death in MADIT II is associated with higher than normal QRS levels in women and higher than in men.
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T-peak to T-end interval for prediction of ventricular tachyarrhythmia and mortality in a primary prevention population with systolic cardiomyopathy
Todd M. Rosenthal,Paul F. Stahls,Freddy M Abi Samra,Michael L. Bernard,Sammy Khatib,Glenn M. Polin,Joel Q. Xue,Daniel P. Morin,Daniel P. Morin +8 more
TL;DR: Tpec independently predicts both VT/VF and overall mortality in patients with systolic dysfunction and ICDs implanted for primary prevention.
References
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Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction.
Arthur J. Moss,Wojciech Zareba,W. Jackson Hall,Helmut U. Klein,David J. Wilber,David S. Cannom,James P. Daubert,Steven L. Higgins,Mary W. Brown,Mark L. Andrews +9 more
TL;DR: In patients with a prior myocardial infarction and advanced left ventricular dysfunction, prophylactic implantation of a defibrillator improves survival and should be considered as a recommended therapy.
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TL;DR: In patients with NYHA class II or III CHF and LVEF of 35 percent or less, amiodarone has no favorable effect on survival, whereas single-lead, shock-only ICD therapy reduces overall mortality by 23 percent.
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An analysis of the time-relations of electrocardiograms
TL;DR: In this paper, a preliminary attempt was made to determine from blood pressure records the relative influence of the heart action and of vaso-canstriction, and it was suggested that it might be necessary to estimate the duration of ventricular systole for different heart rates.
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Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia
Arthur J. Moss,W. Jackson Hall,David S. Cannom,James P. Daubert,Steven L. Higgins,Helmut U. Klein,Joseph H. Levine,Sanjeev Saksena,Albert L. Waldo,David J. Wilber,Mary W. Brown,Moonseong Heo +11 more
TL;DR: In this article, the authors studied whether prophylactic therapy with an implanted cardioverter-defibrillator, as compared with conventional medical therapy, would improve survival in this high-risk group of patients.
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A Randomized Study of the Prevention of Sudden Death in Patients with Coronary Artery Disease
Alfred E. Buxton,Kerry L. Lee,John D. Fisher,Mark E. Josephson,Eric N. Prystowsky,Gail E. Hafley +5 more
TL;DR: Electrophysiologically guided antiarrhythmic therapy with implantable defibrillators, but not with antiarrHythmic drugs, reduces the risk of sudden death in high-risk patients with coronary disease and asymptomatic, unsustained ventricular tachycardia.
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