Key result
Noxious arousal in healthy subjects caused marked changes in T-wave morphology, including T-wave inversion, across all arousal events without altering the overall QT-RR relationship.
Why the study?
Do noxious arousal events induce changes in ventricular repolarisation (QT-RR relationship and T-wave morphology) in healthy subjects?
Observational (n=18)
Do noxious arousal events induce changes in ventricular repolarisation (QT-RR relationship and T-wave morphology) in healthy subjects?
Noxious arousal induces marked T-wave morphology changes in healthy subjects, suggesting abnormal adaptation of repolarization to sudden autonomic shifts.
Answers are grounded in this paper and cite their sources.
T-wave inversions during noxious arousal warrant ECG caution in acute settings; leaves open arrhythmogenic relevance in patients.
Background Sudden arousal has been associated with sudden cardiac death in individuals with ischaemic heart disease, cardiac arrhythmias and the congenital long QT syndrome. This study aimed to determine the effects of arousal on ventricular repolarisation in normal individuals by examining the dynamic QT-interval-heart rate relationship and T-wave morphology changes under various ‘arousal’ scenarios. Methods 18 healthy subjects (6 female, 12 male, median age 22) underwent four separate 24-hour ECG recordings using 2-channel Holter recorders. The protocol contained five different arousal events: Natural Waking (woke naturally, then stood up); Morning Alarm (woken by alarm in the morning, then stood up); Night Alarm (woken by alarm during the night, then stood up); Morning Alarm-Remain Lying (woken by alarm in the morning but remained supine) and Lying to Standing (stood up from a supine position during the day). Holter recordings were analysed using a commercial package for dynamic assessment of the QT-RR relationship. Results In the twenty minutes after arousal no changes were seen in overall QT-RR relationship in any of the groups. However, marked T-wave morphology changes, including T wave inversion, were observed in all the arousal events. Postural changes only accounted for a small proportion of change in T wave morphology. Conclusions In healthy subjects noxious arousal causes marked changes in the morphology of the T wave. This may reflect abnormal adaptation of repolarisation to sudden changes in heart rate and autonomic tone.
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Dweck et al. (2006) conducted an observational in Healthy subjects (n=18). Noxious arousal was evaluated on Dynamic QT-interval-heart rate relationship and T-wave morphology changes. Noxious arousal in healthy subjects caused marked changes in T-wave morphology, including T-wave inversion, across all arousal events without altering the overall QT-RR relationship.
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