Postmyocardial Infarction Patients Susceptible to Ventricular Tachycardia Show Increased T Wave Dispersion Independent of Delayed Ventricular Conduction |
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Authors: | LASSE OIKARINEN,M.D.,,MATTI VIITASALO,M.D.,,PETRI KORHONEN,M.D.,,HEIKKI VÄ Ä NÄ NEN,M.Sc.,,HELENA HÄ NNINEN,M.D.,,JUHA MONTONEN,D.Sc.,,MARKKU MÄ KIJÄ RVI,M.D.,,TOIVO KATILA,D.Sc.,,LAURI TOIVONEN,M.D. |
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Affiliation: | Division of Cardiology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland; Laboratory of Biomedical Engineering, Helsinki University of Technology, Espoo, Finland; BioMag Laboratory, Helsinki University Central Hospital, Helsinki, Finland |
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Abstract: | Arrhythmia Markers After Myocardial Infarction. Introduction: Experimentally, both delayed ventricular conduction and nonhomogeneous ventricular repolarization contribute to reentrant arrhythmias. We tested the hypothesis that increased T wave dispersion is independent of delayed ventricular conduction associated with arrhythmia vulnerability in postmyocardial infarction (post-MI) patients. Methods and Results: We studied 32 post-MI patients with clinical or inducible monomorphic ventricular tachycardia (VT group), 28 post-MI patients without arrhythmias (MI group), and 13 healthy controls, using magnetocardiographic (MCG) mapping with signal averaging. Twelve-lead ECG was the reference. Filtered QRS duration (fQRS) and T wave peak to T wave end interval (TPE) were used as measures of ventricular conduction and nonhomogeneity in ventricular repolarization, respectively. In MCG, the VT group showed the longest fQRS ( 135 ± 34 msec vs 114 ± 22 msec in the MI group; P = 0.012 ). Mean TPE and maximum TPE in VT versus MI groups were 78 ± 9 msec versus 70 ± 6 msec ( P < 0.001 ) and 117 ± 23 msec versus 104 ± 19 msec ( P = 0.020 ), respectively. Maximum TPE did not correlate with fQRS in the VT group ( r = 0.063; P = NS ) but did correlate in the MI group ( r = 0.396; P = 0.037 ). For identification of post-MI patients prone to VT, selection of cutoff values for fQRS > 140 msec and mean TPE > 81 msec gave sensitivity and specificity of 41% and 89%, and 31% and 96%, respectively. Their combination increased sensitivity to 63% while maintaining 89% specificity. Conclusion: Post-MI patients susceptible to VT show increased T wave dispersion independent of delayed ventricular conduction. |
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Keywords: | coronary artery disease magnetocardiography QT dispersion ventricular tachycardia |
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