title: QRS duration and dispersion for predicting ventricular arrhythmias in early stage of acute myocardial infraction.
abstract: OBJECTIVE
  To determine the relationship between QRS duration and dispersion and the occurrence of ventricular arrhythmias in early stages of acute myocardial infarction (AMI).
  
  
  METHODS
  A retrospective, longitudinal descriptive study was carried out.
  
  
  METHODS
  Hospital General Universitario "Camilo Cienfuegos", Sancti Spíritus, Cuba. Secondary health care.
  
  
  METHODS
  A total of 209 patients diagnosed with ST-segment elevation AMI from January 2012 to June 2014.
  
  
  METHODS
  The duration and dispersion of the QT interval, corrected QT interval, and QRS complex were measured in the first electrocardiogram performed at the hospital. The presence of ventricular tachycardia/fibrillation was assessed during follow-up (length of hospital stay).
  
  
  RESULTS
  Arrhythmias were found in 46 patients (22%); in 25 of them (15.9%), arrhythmias originated in ventricles, and were more common in those subjects with extensive anterior wall AMI, which was responsible for 81.8% of the ventricular fibrillations and more than half (57.1%) of the ventricular tachycardias. The widest QRS complexes (77.3±13.3 vs. 71.5±6.4ms; P=.029) and their greatest dispersion (24.1±16.2 vs. 16.5±4.8ms; P=.019) were found on those leads that explore the regions affected by ischemia. The highest values of all measurements were found in extensive anterior wall AMI, with significant differences: QRS 92.3±18.8ms, QRS dispersion 37.9±23.9ms, corrected QT 518.5±72.2ms, and corrected QT interval dispersion 94.9±26.8ms. Patients with higher QRS dispersion values were more likely to have ventricular arrhythmias, with cutoff points at 23.5ms and 24.5ms for tachycardia and ventricular fibrillation, respectively.
  
  
  CONCLUSIONS
  Increased QRS duration and dispersion implied a greater likelihood of ventricular arrhythmias in early stages of AMI than increased duration and dispersion of the corrected QT interval.
authors.affiliation: Departamento de Electrofisiología y Arritmias, Cardiocentro Ernesto Che Guevara, Santa Clara, Villa Clara, Cuba.
authors.forename: E
authors.initials: E
authors.lastname: Chávez-González
authors.affiliation: Servicio de Cardiología, Hospital Universitario Camilo Cienfuegos, Sancti Spíritus, Cuba.
authors.forename: A E
authors.initials: AE
authors.lastname: Rodríguez Jiménez
authors.affiliation: Unidad de Hemodinámica y Cardiología Intervencionista, Cardiocentro Ernesto Che Guevara, Santa Clara, Villa Clara, Cuba. Electronic address: flmorenom@yahoo.com.
authors.forename: F L
authors.initials: FL
authors.lastname: Moreno-Martínez
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000150:complications / Q000175:diagnosis*
keywords: Acute coronary syndrome; Arritmias ventriculares; Dispersión del QRS; Duración del QRS; Intervalo QT; Predictores; Predictors; QRS dispersion; QRS duration; QT interval; Síndrome coronario agudo; Ventricular arrhythmias