Circulation, Vol 80, 1301-1308, Copyright © 1989 by American Heart Association
M Merri, J Benhorin, M Alberti, E Locati and AJ Moss
Quantification of the electrocardiographic ventricular repolarization
involving the T-U wave complex is usually performed with reference to the
axis of the T wave and the QT interval duration. A novel quantitative
approach to improve the description of ventricular repolarization was
applied to the digitized electrocardiograms of 423 normal subjects. Six
electrocardiographic repolarization characteristics were identified:
duration, rate, area, symmetry, late phenomena, and interlead
heterogeneity. A computer algorithm was designed to automatically interpret
the electrocardiographic repolarization segment and measure 11 variables
that quantified these repolarization characteristics. The application of
redundancy-reduction techniques selected a final set of seven variables
that were used in the statistical analysis. The QT interval, which was
included in the initial group of variables, was replaced by the time
interval between S wave offset and T wave maximum. All selected
electrocardiographic variables were independent of age (r2 less than 0.11)
and body surface area (r2 less than 0.03); all except the early duration
variable were heart rate- and QT interval-independent (r2 less than 0.2, r2
less than 0.13, respectively; and most were uncorrelated to each other. A
comparison of repolarization characteristics by gender revealed that
repolarization duration was significantly more prolonged (p less than
0.0001) in women than in men. This multidimensional quantitative approach
conveys a new and more complete description of the repolarization process
and provides an electrocardiographic repolarization database in normal
subjects as a reference standard for identifying patients with disordered
repolarization.
ARTICLES
Electrocardiographic quantitation of ventricular repolarization
Department of Electrical Engineering, University of Rochester, New York.
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