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June 26, 2001Circulation178 citationsOpen Access

Dispersion of Ventricular Depolarization-Repolarization

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PTPietro TurriniDCDomenico CorradoCBCristina Basso

Key Result

QRS dispersion ≥40 ms was the strongest independent predictor of sudden death in ARVC (P<0.0001), with a sensitivity of 90% and specificity of 77%.

Study Design

Type

Case-Control (n=80)

Structured PICO

Do clinical and ECG findings, specifically QT and QRS dispersion, predict the risk of sudden death in patients with arrhythmogenic right ventricular cardiomyopathy?

P
Population
n=80 subjects, comprising 20 sudden death victims with arrhythmogenic right ventricular cardiomyopathy (ARVC) diagnosed at autopsy, 20 living ARVC patients with sustained ventricular tachycardia, 20 living ARVC patients with ≤3 consecutive premature ventricular beats, and 20 control subjects.
I
Intervention
Measurement of clinical and ECG findings, specifically QT and QRS dispersion, negative T wave beyond V1, and syncope.
C
Comparator
Comparison across the four groups (sudden death victims vs. living ARVC patients with varying arrhythmia burden vs. healthy controls).
O
Outcome
Sudden deathhard clinical

QRS dispersion ≥40 ms on a standard ECG is a strong independent predictor of sudden death in patients with arrhythmogenic right ventricular cardiomyopathy, aiding in arrhythmic risk stratification.

Main Result

p-value: p=<0.0001

Abstract

BACKGROUND: We retrospectively investigated the value of clinical and ECG findings as well as QT-QRS dispersion in predicting the risk of sudden death in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). METHODS AND RESULTS: Duration and interlead variability of the QT interval and QRS complex were measured manually from standard ECGs in 20 sudden death victims with ARVC diagnosed at autopsy (group I), in 20 living ARVC patients with sustained ventricular tachycardia (group II), in 20 living ARVC patients with /=40 ms had a sensitivity and specificity of 90% and 77%, respectively; QT dispersion >65 ms, 85% and 75%, respectively; negative T wave beyond V(1), 85% and 42%, respectively; and syncope, 40% and 90%, respectively. CONCLUSIONS: QRS dispersion (>/=40 ms) was the strongest independent predictor of sudden death in ARVC. Syncope, QT dispersion >65 ms, and negative T wave beyond V(1) refined arrhythmic risk stratification in these patients.

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Cite This Study

Turrini et al. (2001) conducted a case-control in arrhythmogenic right ventricular cardiomyopathy (ARVC) (n=80). QT and QRS dispersion vs. Living ARVC patients and healthy controls was evaluated on sudden death (p=<0.0001). QRS dispersion ≥40 ms was the strongest independent predictor of sudden death in ARVC (P<0.0001), with a sensitivity of 90% and specificity of 77%.

synapsesocial.com/papers/6a1216adbb918b6e5b66a355https://doi.org/10.1161/01.cir.103.25.3075
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