Journal Article

Complex T-wave morphology in body surface potential mapping in prediction of arrhythmic events in patients with acute myocardial infarction and cardiac dysfunction

Petri Korhonen, Terhi Husa, Teijo Konttila, Ilkka Tierala, Markku Mäkijärvi, Heikki Väänänen and Lauri Toivonen

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 11, issue 4, pages 514-520
Published in print April 2009 | ISSN: 1099-5129
Published online March 2009 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1093/europace/eup051
Complex T-wave morphology in body surface potential mapping in prediction of arrhythmic events in patients with acute myocardial infarction and cardiac dysfunction

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Aims

Heterogeneous ventricular repolarization is associated with sudden cardiac death after myocardial infarction (MI). This prospective study investigated repolarization disparity with parameters based on T-wave morphology in body surface potential mapping (BSPM) in the assessment of arrhythmia risk in patients with a recent MI and cardiac dysfunction.

Methods and results

Patients (n = 158) had 120-lead BSPM and 12-lead electrocardiogram (ECG) registered soon after acute MI. Principal component analysis (PCA) of the T-wave and T-wave vector loop descriptors were applied to compute parameters describing T-wave morphology and its variation. The study endpoints were arrhythmic events and all-cause mortality. During a mean follow-up of 50 months, 30 patients (19%) died and 16 (10%) had an arrhythmic event. Most of the parameters differed significantly between patients with and without arrhythmic events. In univariate analysis, T-wave vector loop length (TLL) and PCA parameter PCA3 in BSPM and TLL in ECG were significant predictors of arrhythmic events. In multivariate analysis including several clinical variables, these parameters also showed an independent prediction, with parameters in BSPM performing somewhat better. None of the parameters predicted all-cause mortality.

Conclusion

Complex T-wave morphology in BSPM is a marker of arrhythmia propensity in patients with a recent MI and cardiac dysfunction.

Keywords: Heterogeneous repolarization; T-wave morphology; Body surface potential mapping; Ventricular arrhythmias; Myocardial infarction

Journal Article.  3794 words.  Illustrated.

Subjects: Cardiovascular Medicine

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