May
31
2009

Electrocardiographic abnormalities and ventricular tachyarrhythmias after myocardial infarction.

Aims. To assess the association of electrocardiographic repolarization and depolarization patterns to vulnerability to ventricular tachyarrhythmias. Methods. In the present case-control study, a 12-lead ECG, signal-averaged ECG (SAECG), T-wave and QRS morphology, and T-wave alternans (TWA) were analyzed in post-MI patients with and without documented sustained ventricular tachycardia (VT) or fibrillation (VF) (VT/VF group, n = 40, Non-VT/VF group, n = 37, respectively) and healthy subjects (n = 41). Results. The QRS complex duration, measured from standard ECG (128+/-32 ms vs. 102+/-21 ms, p < 0.001) or SAECG (125+/-25 ms vs. 99+/-20 ms, p < 0.001), was significantly longer in the VT/VF than Non-VT/VF group. Several T-wave morphology variables, e.g., the total cosine of the angle between the main vectors of T-wave and QRS loops (TCRT), were different in the VT/VF (-0.13+/-0.58) and Non-VT/VF group (-0.11+/-0.48) compared to the healthy controls (0.47+/-0.50, p < 0.001). However, there were no significant differences in any of the T-wave morphology variables including TWA between the two post-MI groups. Conclusion. Abnormalities in ventricular depolarization are more common among post-MI patients with prior VT/VF than in those without documented ventricular tachyarrhythmias. Abnormal T-wave morphology and TWA seem to reflect the heart disease rather than specifically vulnerability to VT/VF.

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