Enhanced transmural dispersion of repolarization in patients with J wave syndromes

J Cardiovasc Electrophysiol. 2012 Oct;23(10):1109-14. doi: 10.1111/j.1540-8167.2012.02363.x. Epub 2012 May 21.

Abstract

Introduction: Recently, great attention has been paid to the risk stratification of asymptomatic patients with an electrocardiographic early repolarization (ER) pattern. We investigated several repolarization parameters including the Tpeak-Tend interval and Tpeak-Tend/QT ratio in healthy individuals and patients with J wave syndrome who were aborted from sudden cardiac death.

Methods and results: Ninety-two subjects were enrolled: 12 patients with ventricular fibrillation associated with J waves, 40 healthy subjects with an uneventful ER pattern and 40 healthy control subjects (C) without any evident J waves. Using ambulatory electrocardiogram recordings, the average QT interval, corrected QT interval (QTc), Tpeak-Tend (Tp-e) interval, which is the interval from the peak to the end of the T wave, and Tp-e/QT ratio were calculated. Using ANOVA and post hoc analysis, there was no significant difference in the average QT and QTc in all 3 groups (QT; 396 ± 27 vs 405 ± 27 vs 403 ± 27 m, QTc; 420 ± 26 vs 421 ± 21 vs 403 ± 19 milliseconds in the C, ER pattern and J groups, respectively). The Tp-e interval and Tp-e/QT ratio were significantly more increased in the J wave group than the ER Pattern group (Tp-e: 86.7 ± 14 milliseconds vs 68 ± 13.2 milliseconds, P < 0.001, Tp-e/QT; 0.209 ± 0.04 vs 0.171 ± 0.03, P < 0.001), but they did not significantly differ between the C and ER pattern groups (Tp-e: 68.6 ± 7.5 vs 68 ± 13.2, P = 0.97, Tp-e/QT 0.174 ± 0.02 vs 0.171 ± 0.03, P = 0.4).

Conclusion: As novel markers of heterogeneity of ventricular repolarization, Tpeak-Tend interval and Tp-Te/QT ratio are significantly increased in patients with J wave syndromes compared to age and sex-matched uneventful ER.

MeSH terms

  • Action Potentials
  • Adult
  • Aged
  • Analysis of Variance
  • Brugada Syndrome / complications
  • Brugada Syndrome / diagnosis
  • Brugada Syndrome / physiopathology*
  • Brugada Syndrome / therapy
  • Case-Control Studies
  • Death, Sudden, Cardiac / etiology
  • Death, Sudden, Cardiac / prevention & control
  • Electrocardiography, Ambulatory
  • Electrophysiologic Techniques, Cardiac
  • Female
  • Heart Conduction System / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Time Factors
  • Ventricular Fibrillation / complications
  • Ventricular Fibrillation / diagnosis
  • Ventricular Fibrillation / physiopathology*
  • Ventricular Fibrillation / therapy