QT dispersion is not related to infarct size or inducibility in patients with coronary artery disease and life threatening ventricular arrhythmias
a Department of
Cardiology, University Hospital Gent, De Pintelaan 185, 9000 Gent,
Belgium, b Division of Nuclear Medicine, University
Hospital Gent
Correspondence to: Dr De Sutter.
Accepted for publication 27 November 1998
OBJECTIVE
To relate QT
parameters to infarct size and inducibility during electrophysiological studies.
DESIGNAnalysis
of a prospective register.
SETTINGUniversity hospital.
PATIENTS64 patients
with coronary artery disease and documented life threatening
ventricular arrhythmias.
INTERVENTIONSMeasurements
of QT-max, QTc-max, and QT dispersion (QT-d) on a simultaneous 12 lead
ECG (50 mm/s). Estimation of myocardial infarct size with radionuclide
left ventricular ejection fraction (LVEF), echocardiography (left
ventricular end diastolic diameter, LVEDD), and a defect score based on
a quantitative stress redistribution 201-thallium perfusion study.
Electrophysiological study to assess inducibility.
RESULTSMean (SD) QT
parameters were: QT-max 440 (50) ms, QTc-max 475 (46) ms, and QT-d 47 (20) ms. Mean (SD) estimates of infarct size were: LVEF 34 (13)%,
LVEDD 61 (9) mm, and defect score 18 (11). There was no significant
correlation between any index of infarct size and QT parameters. QT
parameters were not significantly different between patients with
inducible (n = 57) and non-inducible arrhythmias (n = 7) (QT-max:
416 (30) v 443 (51) ms, p = 0.18; QTc-max
485 (34) v 473 (47) ms, p = 0.34; QT-d 47 (12) v 47 (21) ms, p = 0.73).
Non-inducible patients had a significant lower defect score: 8 (9)
v 19 (11), p = 0.02, but comparable LVEF: 38 (12)% v 34 (12)%, p = 0.58, and
LVEDD: 54 (10) v 61 (8) mm, p = 0.13.
CONCLUSIONSQT
parameters are not influenced by infarct size and do not predict
inducibility during electrophysiological study in patients with
coronary artery disease and malignant ventricular arrhythmias. In
contrast, the amount of scar tissue determined by perfusion imaging is
strongly correlated with inducibility.
Keywords: QT parameters; infarct size; electrophysiological testing; perfusion imaging
© 1999 by Heart
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