title: ECG-based estimation of dispersion of APD restitution as a tool to stratify sotalol-induced arrhythmic risk.
abstract: BACKGROUND
  Increased spatial dispersion of restitution properties has been associated to arrhythmic risk. An ECG-based index quantifying restitution dispersion, DRest, is evaluated in patients who experienced Torsades de Pointes (TdP) under sotalol challenge and compared with the response in healthy subjects.
  
  
  RESULTS
  ECG recordings were analyzed for quantification of DRest and QTc, among others biomarkers. DRest provides improved discrimination following sotalol administration between TdP and healthy subjects ([min-max]: [0.18-0.22] vs [0.02-0.12]), compared to other biomarkers including QTc ([436-548ms] vs [376-467ms]). Results in healthy subjects are in agreement with simulations of sotalol effects on a human tissue electrophysiological model.
  
  
  CONCLUSIONS
  This case study supports the potential of DRest for improved arrhythmia risk stratification even with QTc values below 450ms.
authors.affiliation: Department of Computer Science, University of Oxford, Oxford, United Kingdom. Electronic address: ana.minchole@cs.ox.ac.uk.
authors.forename: A
authors.initials: A
authors.lastname: Mincholé
authors.affiliation: Department of Computer Science, University of Oxford, Oxford, United Kingdom.
authors.forename: A
authors.initials: A
authors.lastname: Bueno-Orovio
authors.affiliation: Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Spain; BSICoS Group, Aragón Institute of Engineering Research (I3A), IIS Aragón, Universidad de Zaragoza, Zaragoza, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Laguna
authors.affiliation: Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Spain; BSICoS Group, Aragón Institute of Engineering Research (I3A), IIS Aragón, Universidad de Zaragoza, Zaragoza, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Pueyo
authors.affiliation: Department of Computer Science, University of Oxford, Oxford, United Kingdom.
authors.forename: B
authors.initials: B
authors.lastname: Rodriguez
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000009:adverse effects; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D006801:Humans; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D013015:Sotalol / Q000009:adverse effects*; D016171:Torsades de Pointes / Q000139:chemically induced* / Q000175:diagnosis* / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D013015:Sotalol
keywords: APD restitution; Rate adaptation; cardiotoxicity; sotalol