Abstract 10896: Utility of the T-peak to T-end Interval for Long-term Prediction of Ventricular Tachyarrhythmia and Mortality Among Patients With Cardiomyopathy
Introduction: The T wave peak to T-end interval on surface electrocardiogram has been shown to correlate with dispersion of ventricular repolarization (DVR). Increased DVR can increase propensity toward electrical reentry that can cause ventricular tachyarrhythmia. Some evidence shows that among patients with cardiomyopathy, intermediate-term ventricular tachyarrhythmia and overall mortality can be predicted by the heart rate-corrected T wave peak to T-end interval (Tpec). Data with long-term follow-up are lacking.
Methods: Enrollment consisted of 327 patients (75% M, LVEF 23±7%) with LVEF ≤ 35% and an ICD. Using the automated previously validated GE Healthcare algorithm 12SL, ECGs were analyzed at baseline. Endpoints were VT/VF, death, and a combined endpoint of VT/VF or death as assessed by prospective device clinic follow-up and Social Security Death Index query.
Results: The average Tpec was 108±23 ms. Over device clinic follow-up of 30±23 months, 93 (28%) patients had at least one appropriate ICD therapy for VT/VF, and over mortality follow-up of 50±21 months, 99 (30%) patients died. On univariable analysis, Tpec predicted VT/VF, death, and the combination of VT/VF or death (p<0.01 for each endpoint; see Figures stratified by tertiles of Tpec: T1, T2, T3).
Multivariable analysis included univariable predictors among demographics, clinical data, laboratory data, medication use, and ECG parameters. After correction, Tpec remained predictive of VT/VF (HR per 10 ms increase: 1.18, p<0.001), all-cause mortality (HR per 10 ms: 1.14, p=0.02), and the combined endpoint of VT/VF or death (HR per 10 ms: 1.15, p=0.001).
Conclusion: Tpec independently predicts both VT/VF and overall mortality in patients with systolic dysfunction and an implanted ICD, and may be used for long-term risk stratification.
- © 2013 by American Heart Association, Inc.