Predictive Value of Ventricular Transmural Dispersion of Repolarization on Rapid Ventricular Tachycardia Risk in Patients After Resynchronization
10.3969/j.issn.1000-3614.2014.10.009
- VernacularTitle:心室跨壁复极离散度预测心脏再同步治疗除颤器术后快速室性心律失常的风险
- Author:
Jing HE
;
Ji YAN
;
Jian XU
;
Xianlin SUN
;
Hao SU
;
Fei YU
;
Kuangyu CHEN
- Publication Type:Journal Article
- Keywords:
Tp-Td interval;
Transmural dispersion of repolarization;
Cardiac resynchronization therapy deifbrillator
- From:
Chinese Circulation Journal
2014;(10):791-795
- CountryChina
- Language:Chinese
-
Abstract:
Objective: Cardiac resynchronization therapy defibrillator (CRT-D) increases ventricular transmural dispersion of repolarization (TDR). Our work evaluated the relationship between QTc interval of TDR indicators, TpTe, TpTe/QTc ratio and rapid ventricular arrhythmia in patients with CRT-D. Methods: A total of 160 consecutive patients who received CRT-D implantation in our hospital from 2011-01 to 2013-03 were studied. The immediate post operative ECG was collected to analyze lead V5 QTc interval, TpTe and TpTe/QTc ratio for assessing its TDR. The patients were divided into 2 groups: Treatment group, the patients with ventricular tachycardia or ventricular ifbrillation received CRT-D,n=30 (18.7%) and Non-treatments group,n=130 (81.3%). All patients were followed-up for (20 ± 10) months and the rapid ventricular arrhythmia was recorded by CRT-D devices. Results: The patients in Treatment group had increased TpTe/QTc (0.24 ± 0.05) vs (0.20 ± 0.04, and TpTe (119 ± 30) ms vs (95 ± 20) ms, bothP<0.001. The QTc interval was similar between 2 groups (480 ± 60) ms vs (470 ± 70) ms,P=0.6 and QTc interval was not related to the risk of CRT-D requirement. The sensitivity and speciifcity for TpTe/QTc ≥ 0.25 predicting the risk of ventricular arrhythmia in CRT-D patients were at 47% and 91%, while TpTe ≥ 120 ms were at 40% and 95%respectively. The post CRT-D surviving curve analysis indicated that TpTe/QTc ratio and TpTe could predict the prognosis in relevant patients,P<0.001. Conclusion: The elevated TpTe and TpTe/QT ratio may increase the incidence of CRT-D requirement in patients with ventricular arrhythmia after resynchronization.
