Skip Navigation



Europace Advance Access published online on July 17, 2007
Europace, doi:10.1093/europace/eum131
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
9/9/717    most recent
eum131v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Couderc, J.-P.
Right arrow Articles by Moss, A. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Couderc, J.-P.
Right arrow Articles by Moss, A. J.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

ORIGINAL ARTICLE

Repolarization variability in the risk stratification of MADIT II patients

Jean-Philippe Couderc1,*, Wojciech Zareba1, Scott McNitt1, Pierre Maison-Blanche2,3 and Arthur J. Moss1

1 Heart Research Follow-up Program, Cardiology, University of Rochester Medical Center, Box 653 Rochester, NY 14642, USA; 2 Hopital Lariboisière, Paris, France; 3 Ela Medical, Paris, France

Aims QT variability has been reported to be associated with ventricular arrhythmias and sudden cardiac death. There is limited data regarding variability in T-wave morphology and its prognostic value. In this study, we present a novel approach for the measurement of T-wave variability (TWV) reflecting changes in T-wave morphology, and we investigate the prognostic significance of Holter-derived TWV in patients with and without ventricular arrhythmias requiring appropriate implantable cardioverter defibrillator (ICD) therapy from the Multicenter Automatic Defibrillator Implantation Trial II (MADIT II).

Methods Study population consisted of 275 ICD patients from MADIT II after excluding patients with intraventricular conduction abnormalities or atrial fibrillation. TWV was measured based on amplitude variance of T-wave amplitude.

Results During 2-year follow-up, 58 (21%) patients had appropriate ICD therapy for ventricular tachycardia or fibrillation. Patients with appropriate ICD therapy had higher levels of TWV measures than those without arrhythmic events. After adjustment for heart rate, ejection fraction, and significant clinical predictors of arrhythmic events, a Cox proportional-hazards regression model revealed that dichotomized TWV values were predictive for ventricular tachyarrhythmias requiring appropriate ICD therapy (hazard ratio, 2.0; 95% CI; 1.2–3.5; P = 0.01). On the basis of the comprehensive testing, TWV value >59 µV was found predictive for arrhythmic events in MADIT II population.

Conclusion Our newly designed method for the assessment of repolarization variability in ambulatory Holter recordings detected transient variability of T-wave morphology, which was predictive for ventricular tachyarrhythmias in the MADIT II population.

Key Words: T-wave variability, MADIT II, Risk stratification

* Corresponding author. Tel: +1 585 275 1096; fax: +1 585 273 5283. E-mail address: jean-philippe.couderc{at}heart.rochester.edu

Manuscript submitted 26 February 2007. Accepted after revision 12 June 2007.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Phil Trans R Soc AHome page
J.-P. Couderc
Measurement and regulation of cardiac ventricular repolarization: from the QT interval to repolarization morphology
Phil Trans R Soc A, April 13, 2009; 367(1892): 1283 - 1299.
[Abstract] [Full Text] [PDF]

Home page
 EuropaceHome page
P. Korhonen, T. Husa, T. Konttila, I. Tierala, M. Makijarvi, H. Vaananen, and L. Toivonen
Complex T-wave morphology in body surface potential mapping in prediction of arrhythmic events in patients with acute myocardial infarction and cardiac dysfunction
Europace, April 1, 2009; 11(4): 514 - 520.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
E. J. Rashba, G. A. Lamas, J.-P. Couderc, S. M. Hollist, V. Dzavik, W. Ruzyllo, V. Fridrich, C. E. Buller, S. A. Forman, J. A. Kufera, et al.
Electrophysiological Effects of Late Percutaneous Coronary Intervention for Infarct-Related Coronary Artery Occlusion: The Occluded Artery Trial-Electrophysiological Mechanisms (OAT-EP)
Circulation, February 17, 2009; 119(6): 779 - 787.
[Abstract] [Full Text] [PDF]

Home page
 Phil Trans R Soc AHome page
E. Pueyo, J. P. Martinez, and P. Laguna
Cardiac repolarization analysis using the surface electrocardiogram
Phil Trans R Soc A, January 28, 2009; 367(1887): 213 - 233.
[Abstract] [Full Text] [PDF]

Home page
 J Clin PharmacolHome page
J.-P. Couderc, S. Kaab, M. Hinterseer, S. McNitt, X. Xia, A. Fossa, B. M. Beckmann, S. Polonsky, and W. Zareba
Baseline Values and Sotalol-Induced Changes of Ventricular Repolarization Duration, Heterogeneity, and Instability in Patients With a History of Drug-Induced Torsades de Pointes
J. Clin. Pharmacol., January 1, 2009; 49(1): 6 - 16.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.