[QT-dispersion in the surface ECG as a parameter of increased electrical vulnerability in acute myocardial ischemia].
QT-dispersion defined as the difference between QTmax and QTmin in the 12-lead surface ECG was determined in 33 patients with acute myocardial infarction treated by intravenous thrombolysis. In 11 patients, ventricular fibrillation ensured during the first 24 h after hospital admission. These patients were then compared with 22 matching infarction patients without malignant ventricular rhythm disturbances. QT-dispersion as evaluated in the first ECG taken after hospital admission was significantly higher in patients with (88 +/- 16 ms) compared to QT-dispersion in patients without ventricular fibrillation (66 +/- 19 ms; p < 0.001). When QT-dispersion was again assessed in ECG tracings recorded prior to hospital discharge, it was markedly reduced, with no significant difference between either patient group (53 +/- 16 ms versus 54 +/- 18 ms). These results indicate that QT-dispersion in the surface ECG represents a marker of inhomogeneous repolarization in patients with acute myocardial infarction prone to ventricular fibrillation. This may allow early identification of high-risk patients soon after hospital admission.
Hohnloser
S H
SH
Medizinische Universitätsklinik III, Freiburg im Breisgau.
van de Loo
A
A
Arendts
W
W
Zabel
M
M
Just
H
H
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D015716:Electrocardiography, Ambulatory / Q000187:drug effects; D005260:Female; D006329:Heart Conduction System / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D008133:Long QT Syndrome / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000503:physiopathology*; D017202:Myocardial Ischemia / Q000188:drug therapy / Q000503:physiopathology*; D012815:Signal Processing, Computer-Assisted; D015912:Thrombolytic Therapy; D014693:Ventricular Fibrillation / Q000188:drug therapy / Q000503:physiopathology*
D000319:Adrenergic beta-Antagonists
QT-Dispersion im Oberflächen-EKG als Parameter einer gesteigerten elektrischen Vulnerabilität bei akuter Myokardischämie.