Key result
Recovery time dispersion from 87-lead mapping was significantly larger in idiopathic DCM patients with sustained VT compared to those without (236 vs 184 msec, P<0.001).
Why the study?
Does recovery time dispersion measured from 87-lead body surface potential mapping improve the identification of patients at risk for sustained ventricular tachycardia in idiopathic dilated cardiomyopathy compared to standard 12-lead ECG?
Case-Control (n=53)
Does recovery time dispersion measured from 87-lead body surface potential mapping improve the identification of patients at risk for sustained ventricular tachycardia in idiopathic dilated cardiomyopathy compared to standard 12-lead ECG?
Absolute Event Rate: 236% vs 184%
p-value: p=< 0.001
Recovery time dispersion measured by 87-lead body surface potential mapping is superior to standard 12-lead ECG parameters for identifying idiopathic dilated cardiomyopathy patients at risk for sustained ventricular tachycardia.
May aid VT risk stratification in idiopathic DCM; hypothesis-generating and requires prospective validation vs 12-lead ECG.
INTRODUCTION: The clinical usefulness of QT dispersion in 12-lead ECG has been controversial in identifying subjects at risk for sustained ventricular tachycardia (VT) in patients with idiopathic dilated cardiomyopathy (DCM). We hypothesized that increasing the spatial resolution of the ECG improves the accuracy of risk stratification. The purpose of this study was to test the ability of recovery time dispersion measured from 87-lead body surface potential mapping (BSPM) to identify patients at risk for sustained VT in idiopathic DCM. METHODS AND RESULTS: We obtained 87-lead BSPM and 12-lead ECG in 33 patients with idiopathic DCM (15 patients with a history of sustained VT [VT(+) group] and 18 patients without a history of sustained VT [VT(-) group]) and in 20 normal control subjects. We measured the corrected QT dispersion and corrected recovery time dispersion from 12-lead ECG (QTc-12 dispersion and RTc-12 dispersion, respectively) and 87-lead BSPM (QTc-87 dispersion and RTc-87 dispersion, respectively). Signal-averaged ECG also was recorded in 25 patients. Neither the QTc-12 nor QTc-87 dispersion discriminated between the VT(+) and VT(-) groups patients. The VT(+) group patients had a larger but insignificant RTc-12 dispersion than the VT(-) group patients. In contrast, the RTc-87 dispersion was significantly larger in the VT(+) group patients than in the VT(-) group patients (236 +/- 39 msec vs 184 +/- 28 msec, P < 0.001). Receiver operating curve analysis indicated that the RTc-87 dispersion was as good as late potentials in predicting susceptibility to sustained VT; its sensitivity, specificity, and negative predictive value were 73%, 76%, and 76%, respectively (cutoff value 200 msec). RTc-87 dispersion >200 msec combined with positive late potentials provide high sensitivity (92%) and high negative predictive value (88%) for sustained VT. CONCLUSION: The RTc-87 dispersion is a useful tool to identify subjects at risk for sustained VT in patients with idiopathic DCM.
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Aiba et al. (2000) conducted a case-control in Idiopathic Dilated Cardiomyopathy (n=53). Recovery time dispersion measured from 87-lead body surface potential mapping (RTc-87 dispersion) vs. Patients without a history of sustained VT was evaluated on RTc-87 dispersion (p=< 0.001). Recovery time dispersion from 87-lead mapping was significantly larger in idiopathic DCM patients with sustained VT compared to those without (236 vs 184 msec, P<0.001).
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