Minimal T-wave representation and its use in the assessment of drug arrhythmogenicity

Ann Noninvasive Electrocardiol. 2017 May;22(3):e12413. doi: 10.1111/anec.12413. Epub 2016 Oct 27.

Abstract

Background: Recently, numerous models and techniques have been developed for analyzing and extracting features from the T wave which could be used as biomarkers for drug-induced abnormalities. The majority of these techniques and algorithms use features that determine readily apparent characteristics of the T wave, such as duration, area, amplitude, and slopes.

Methods: In the present work the T wave was down-sampled to a minimal rate, such that a good reconstruction was still possible. The entire T wave was then used as a feature vector to assess drug-induced repolarization effects. The ability of the samples or combinations of samples obtained from the minimal T-wave representation to correctly classify a group of subjects before and after receiving d,l-sotalol 160 mg and 320 mg was evaluated using a linear discriminant analysis (LDA).

Results: The results showed that a combination of eight samples from the minimal T-wave representation can be used to identify normal from abnormal repolarization significantly better compared to the heart rate-corrected QT interval (QTc). It was further indicated that the interval from the peak of the T wave to the end of the T wave (Tpe) becomes relatively shorter after IKr inhibition by d,l-sotalol and that the most pronounced repolarization changes were present in the ascending segment of the minimal T-wave representation.

Conclusions: The minimal T-wave representation can potentially be used as a new tool to identify normal from abnormal repolarization in drug safety studies.

Keywords: QT interval; T wave; Tpeak-Tend; electrocardiogram; repolarization.

MeSH terms

  • Adolescent
  • Adult
  • Anti-Arrhythmia Agents / pharmacology*
  • Electrocardiography / drug effects*
  • Electrocardiography / statistics & numerical data
  • Heart / drug effects
  • Humans
  • Male
  • Middle Aged
  • Reference Values
  • Sotalol / pharmacology*
  • Young Adult

Substances

  • Anti-Arrhythmia Agents
  • Sotalol