Key result
Ventricular arrhythmias and abnormal T-wave morphology are linked to significantly prolonged TpTe intervals.
Why the study?
Ventricular repolarization changes can assess electrical instability that may lead to life-threatening ventricular arrhythmias, motivating an evaluation of T-wave morphology and repolarization parameters in resting ECGs of children with ventricular arrhythmias.
Does the presence of ventricular arrhythmias and abnormal T-wave morphology prolong repolarization parameters (TpTe, QTc) in children compared to healthy controls?
Case-Control (n=80)
Blind analysis of ECGs by two independent investigators
No
Does the presence of ventricular arrhythmias and abnormal T-wave morphology prolong repolarization parameters (TpTe, QTc) in children compared to healthy controls?
p-value: p=<0.001
Evaluating the TpTe interval in children with ventricular arrhythmias may help identify those with greater electrical myocardial instability who require closer monitoring.
TpTe prolongation may mark greater instability in children with ventricular arrhythmias; hypothesis-generating for risk stratification, needs prospective validation.
Background: The changes in the period of ventricular repolarization, i.e., QT interval, QTp (Q-Tpeak) and TpTe interval (Tpeak–Tend), make it possible to assess the electrical instability of the heart muscle, which may lead to the development of life-threatening ventricular arrhythmia. The aim of the study was to determine and evaluate the use of differences in T-wave morphology and durations of repolarization period parameters (QT, TpTe) in resting ECGs for children with ventricular arrhythmias. Methods: The retrospective analysis was made of the disease histories of 80 examined children with resting ECGs, which were admitted to the Children’s Cardiology Department. The study group consisted of 46 children aged 4 to 18 with ventricular arrhythmias and the control group consisted of 34 healthy children between 4 and 18 years of age, with no arrhythmias. Results: The duration of the TpTe interval was significantly (p < 0.001) longer in the group of children with ventricular arrhythmia with abnormal T-wave (bactrian/bifid, humid/biphasic) compared to the TpTe interval in children with ventricular arrhythmia with the normal repolarization period. The duration of the TpTe (p < 0.001), QTcB (p < 0.001) and QTcF (p < 0.001) intervals were significantly longer in the group of children with ventricular arrhythmias and with abnormal T-wave compared to the values of the TpTe, QTcB, and QTcF intervals of the control group with normal morphology of the repolarization period. Only the duration of the TpTe interval was significantly (p = 0.020) longer in the group of children with ventricular arrhythmia without clinical symptoms. Conclusions: Children with benign ventricular arrhythmias recorded on a standard ECG with prolonged TpTe and QT intervals and abnormal T-wave morphology require systematic and frequent cardiac check up with long term ECG recordings due to the possibility of future more severe ventricular arrhythmias. Further follow-up studies in even larger groups of patients are necessary to confirm the values of these repolarization parameters in clinical practice.
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Jaromin et al. (2021) conducted a case-control in Ventricular arrhythmias (n=80). Ventricular arrhythmias with abnormal T-wave morphology vs. Healthy children with normal repolarization morphology was evaluated on Duration of the TpTe interval (p=<0.001). Ventricular arrhythmias and abnormal T-wave morphology were associated with a significantly prolonged TpTe interval compared to healthy controls (p < 0.001).
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