T-Wave Morphology Restitution Predicts Sudden Cardiac Death in Patients With Chronic Heart Failure [Health Services and Outcomes Research]

BackgroundPatients with chronic heart failure are at high risk of sudden cardiac death (SCD). Increased dispersion of repolarization restitution has been associated with SCD, and we hypothesize that this should be reflected in the morphology of the T‐wave and its variations with heart rate. The aim of this study is to propose an electrocardiogram (ECG)‐based index characterizing T‐wave morphology restitution (TMR), and to assess its association with SCD risk in a population of chronic heart failure patients.Methods and ResultsHolter ECGs from 651 ambulatory patients with chronic heart failure from the MUSIC (MUerte Súbita en Insuficiencia Cardiaca) study were available for the analysis. TMR was quantified by measuring the morphological variation of the T‐wave per RR increment using time‐warping metrics, and its predictive power was compared to that of clinical variables such as the left ventricular ejection fraction and other ECG‐derived indices, such as T‐wave alternans and heart rate variability. TMR was significantly higher in SCD victims than in the rest of patients (median 0.046 versus 0.039, P

Source: JAHA:Journal of the American Heart Association - May 19, 2017 Category: Cardiology Authors: Ramirez, J., Orini, M., Minchole, A., Monasterio, V., Cygankiewicz, I., Bayes de Luna, A., Martinez, J. P., Pueyo, E., Laguna, P. Tags: Arrhythmias, Sudden Cardiac Death, Biomarkers, Heart Failure, Mortality/Survival Original Research Source Type: research