A Tpeak-Tend interval ≥123 ms at the 10th minute of ischemia predicted delayed ventricular fibrillation in a porcine myocardial infarction model (HR 4.5; 95% CI 1.1-17.8; P=0.031).
Does Tpeak-Tend prolongation during ischemia progression predict ventricular fibrillation in a porcine myocardial infarction model?
Tpeak-Tend prolongation during acute ischemia predicts ventricular fibrillation in a porcine model, suggesting potential utility for risk stratification in acute coronary syndromes.
Effect estimate: HR 4.5 (95% CI 1.1-17.8)
p-value: p=0.031
Aims: Repolarization indices of ECG have been widely assessed as predictors of ventricular arrhythmias. However, little is known of the dynamic changes of these parameters during continuous monitoring in acute ischaemic episodes. The objective of the study was to evaluate repolarization-related predictors of ventricular fibrillation (VF) during progression of experimental myocardial infarction. Methods and results: Myocardial infarction was induced in 27 pigs by 40-min balloon inflation in the left anterior descending coronary artery, and 12-lead ECG was continuously recorded. Rate-corrected durations of the total Tpeak-Tend intervals measured from the earliest T-wave peak to the latest T-wave end in any lead were determined at baseline and at minute 1, 2, 5, and then every 5th minute of occlusion. There were 7 early (1-3 min) and 10 delayed (15-30 min) VFs in 16 pigs. Baseline Tpeak-Tend did not differ between animals with and without VF. Tpeak-Tend interval rapidly increased immediately after balloon inflation and was greater in VF-susceptible animals at 2-15 min compared with the animals that never developed VF (P < 0.05). Tpeak-Tend was tested as a predictor of delayed VFs. Median Tpeak-Tend at 10th min of occlusion was higher in delayed VF group (n = 10) than in animals without VF (n = 11): 138 IQR 121-148 ms vs. 111 IQR 106-127 ms, P = 0.02. Tpeak-Tend ≥123 ms (10th min) predicted delayed VF episodes with HR = 4.5 95% CI 1.1-17.8, P = 0.031. Conclusion: Tpeak-Tend prolongation during ischaemia progression predicts VF in the experimental porcine myocardial infarction model and warrants further testing in clinical settings of acute coronary syndromes.
Azarov et al. (Wed,) conducted a other in Myocardial infarction (n=27). Tpeak-Tend interval ≥123 ms vs. Tpeak-Tend interval <123 ms was evaluated on Delayed ventricular fibrillation (HR 4.5, 95% CI 1.1-17.8, p=0.031). A Tpeak-Tend interval ≥123 ms at the 10th minute of ischemia predicted delayed ventricular fibrillation in a porcine myocardial infarction model (HR 4.5; 95% CI 1.1-17.8; P=0.031).