Key result
In patients with left ventricular systolic dysfunction and an ICD, a longer Tpe(c) independently predicted the composite of appropriate ICD therapy or death.
Why the study?
Does the T-peak to T-end interval predict appropriate ICD therapy and mortality in patients with left ventricular systolic dysfunction and an ICD?
Cohort (n=327)
Does the T-peak to T-end interval predict appropriate ICD therapy and mortality in patients with left ventricular systolic dysfunction and an ICD?
Answers are grounded in this paper and cite their sources.
In patients with left ventricular systolic dysfunction and an ICD, a prolonged T-peak to T-end interval on ECG is an independent predictor of ventricular tachyarrhythmias and mortality.
AIMS: The interval between the T-wave's peak and end (Tpe), an electrocardiographic (ECG) index of ventricular repolarization, has been proposed as an indicator of arrhythmic risk. We aimed to clarify the clinical usefulness of Tpe for risk stratification. METHODS AND RESULTS: We evaluated 327 patients with left ventricular ejection fraction (LVEF) ≤ 35% (75% male, LVEF 23 ± 7%). All patients had an implanted implantable cardioverter-defibrillator (ICD). Clinical data and ECGs were analysed at baseline. Prospective follow-up for the endpoints of appropriate ICD therapy and mortality was conducted via periodic device interrogation, chart review, and the Social Security Death Index. During device clinic follow-up of 17 ± 12 months, 59 (18%) patients had appropriate ICD therapy, and during mortality follow-up of 30 ± 13 months, 67 (21%) patients died. A longer Tpe(c) predicted appropriate ICD therapy, death, and the combination of appropriate ICD therapy or death (P< 0.01 for each endpoint). On multivariable analysis correcting for other univariable predictors, Tpe(c) remained predictive of ICD therapy [hazard ratio (HR) per 10 ms increase: 1.16, P= 0.02], all-cause mortality (HR per 10 ms: 1.14, P= 0.03), and the composite endpoint of ICD therapy or death (HR per 10 ms: 1.16, P< 0.01). CONCLUSIONS: In patients with left ventricular systolic dysfunction and an implanted ICD, Tpe(c) independently predicts both ventricular tachyarrhythmia and overall mortality.
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Morin et al. (2012) conducted a cohort in Left ventricular systolic dysfunction (n=327). T-peak to T-end interval (Tpe(c)) vs. Shorter Tpe(c) (evaluated per 10 ms increase) was evaluated on Composite of appropriate ICD therapy or death (HR 1.16, p=<0.01). In patients with left ventricular systolic dysfunction and an ICD, a longer Tpe(c) independently predicted the composite of appropriate ICD therapy or death.
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