UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Differences in the Upslope of the Precordial Body Surface ECG T-Wave Reflect Right To Left Dispersion of Repolarization in the Intact Human Heart

Srinivasan, NT; Orini, M; Providencia, R; Simon, R; Lowe, M; Segal, OR; Chow, AW; ... Lambiase, PD; + view all (2018) Differences in the Upslope of the Precordial Body Surface ECG T-Wave Reflect Right To Left Dispersion of Repolarization in the Intact Human Heart. Heart Rhythm 10.1016/j.hrthm.2018.12.006. (In press). Green open access

[img]
Preview
Text
Srinivasan_1-s2.0-S154752711831261X-main.pdf - Published version

Download (2MB) | Preview

Abstract

BACKGROUND: The relationship between the surface ECG T-wave to intracardiac repolarization is poorly understood. OBJECTIVES: This study aimed to examine the association between intracardiac ventricular repolarization and the T-wave on the body surface ECG (SECGTW). METHODS: 10 normal heart patients (age 35 +/- 15yrs, 6Male), were studied. Decapolar EP catheters were placed in the right ventricle (RV) and lateral left ventricle (LV) to record in an apico-basal orientation and lateral LV branch of the coronary sinus (CS) for transmural (TM) recording. Each catheter (CS, LV, RV) was sequentially paced using an S1-S2 restitution protocol. Intracardiac repolarization time (RT) and apico-basal, RV-LV and TM repolarization dispersion were correlated with the SECGTW, with a total of 23,946 T-waves analyzed. RESULTS: RV endocardial repolarization occurred on the upslope of lead V1, V2 and V3 SECGTW with a sensitivity of 0.89, 0.91 and 0.84, and a specificity of 0.67, 0.68 and 0.65 respectively. LV basal endocardial, epicardial and mid endocardial repolarization occurred on the upslope of lead V6 and I, with a sensitivity of 0.79 and 0.8, and specificity of 0.66 and 0.67. Differences between the end of the upslope in V1, V2 and V3 vs V6 strongly correlated with right to left dispersion of repolarization (ICC 0.81, 0.83, 0.85 respectively, p<0.001). Poor association between the T-wave to apicobasal and transmural dispersion of repolarization was seen. CONCLUSION: The precordial SECGTW reflects regional repolarization differences between right and the left heart. These findings have important implications for accurately identifying biomarkers of arrhythmogenic risk in disease.

Type: Article
Title: Differences in the Upslope of the Precordial Body Surface ECG T-Wave Reflect Right To Left Dispersion of Repolarization in the Intact Human Heart
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.hrthm.2018.12.006
Publisher version: https://doi.org/10.1016/j.hrthm.2018.12.006
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
Keywords: Body Surface ECG, Dispersion of Repolarization, Surface ECG, T-wave, T-wave Genesis, Tpeak-Tend, Ventricular Repolarizaiton
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Cardiovascular Science > Clinical Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Health Informatics
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Health Informatics > Clinical Epidemiology
URI: https://discovery.ucl.ac.uk/id/eprint/10065445
Downloads since deposit
52Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item