The association between T-wave morphology and life-threatening ventricular tachyarrhythmias in patients with congestive heart failure.
BACKGROUND
Whether T-wave morphology descriptors on the 12-lead electrocardiogram (ECG) can predict the occurrence of life-threatening ventricular arrhythmia in patients with advanced congestive heart failure is unclear.


METHODS
Standard 12-lead ECGs were photoscanned and digitized for analysis in 27 heart failure patients with ventricular tachycardia/ventricular fibrillation (VT/VF; study group), as well as in 54 age- and sex-matched heart failure patients without life-threatening ventricular arrhythmia as a control group. Novel T-wave morphology descriptors were compared.


RESULTS
The results showed that the temporal descriptor, the lead dispersion (LD; 426.5 +/- 279.8 vs 189.0 +/- 125.7, P < 0.001), was significantly higher in the study than in the control group. The other T-wave morphology parameters, such as the T-wave morphology dispersion (45.7 +/- 20.1 vs 44.9 +/- 18.6), the total cosine between QRS and T wave (TCRT; -0.4 +/- 0.4 vs -0.5 +/- 0.3), and the normalized T-loop area (NTLA; 0.5 +/- 0.1 vs 0.4 +/- 0.1), were not significantly different between the two groups (all P value > 0.05). After an adjustment for other clinical variables, increased LD (odds ratio: 9.9, 95% confidence interval [CI]: 2.9-33.4, P < 0.001) or decreased NTLA (odds ratio: 0.4, 95% CI: 0.1-1.0, P =0.05) was associated with VT/VF.


CONCLUSIONS
The novel T-wave morphology analysis may help in identifying heart failure patients at high risk for VT/VF.
Lin
Yen-Hung
YH
Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Lin
Lian-Yu
LY
Chen
Ying-Shren
YS
Huang
Hui-Chun
HC
Lee
Jen-Kuang
JK
Ho
Yi-Lwun
YL
Liao
Lin-Chu
LC
Chen
Wen-Jone
WJ
D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000175:diagnosis*; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000150:complications* / Q000175:diagnosis*