December 9, 2011Circulation Arrhythmia and Electrophysiology
Crescendo in Depolarization and Repolarization Heterogeneity Heralds Development of Ventricular Tachycardia in Hospitalized Patients With Decompensated Heart Failure
Why the study?
Do changes in depolarization and repolarization heterogeneity (RWH, TWH, TWA) precede the development of ventricular tachycardia in hospitalized patients with acute decompensated heart failure?
Population
44 hospitalized patients with acute decompensated heart failure enrolled in the PRECEDENT trial, including…
Comparison
Ambulatory ECG analysis of R-wave heterogeneity… vs Age- and sex-matched patients without VT.
Design
Case-control
Follow-up
24-hour period
Authors
Discussion
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Member takes
Implication
May herald imminent VT in ADHF via ambulatory ECG; hypothesis-generating, requires prospective validation before practice change.
Structured PICO
Do changes in depolarization and repolarization heterogeneity (RWH, TWH, TWA) precede the development of ventricular tachycardia in hospitalized patients with acute decompensated heart failure?
P
Population
44 hospitalized patients with acute decompensated heart failure enrolled in the PRECEDENT trial, including 22 who experienced episodes of ventricular tachycardia (VT, ≥4 beats at heart rates >100 beats/min) following ≥120 minutes of stable sinus rhythm, and 22 age- and sex-matched patients without VT.
I
Intervention
Ambulatory ECG analysis of R-wave heterogeneity (RWH), T-wave heterogeneity (TWH), and T-wave alternans (TWA) before initiation of drug therapy.
C
Comparator
Age- and sex-matched patients without VT.
O
Outcome
Changes in RWH, TWH, and TWA preceding the onset of ventricular tachycardia.surrogate
Tracking depolarization and repolarization heterogeneity on ambulatory ECG can detect crescendos in electrical instability that forewarn of impending nonsustained ventricular tachycardia in patients with decompensated heart failure.
Cite This Study
Nearing et al. (2011) studied this question.