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Comparisons of the Spatial QRS-T Angle with Intra-cardiac Markers of Depolarization and Repolarization

Young, WJ; Srinivasan, N; Tinker, A; Munroe, PB; Lambiase, PD; Orini, M; (2020) Comparisons of the Spatial QRS-T Angle with Intra-cardiac Markers of Depolarization and Repolarization. In: Proceedings of 2020 Computing in Cardiology (CinC 2020). Computing in Cardiology (CinC): Rimini, Italy. Green open access

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Abstract

The spatial QRS-T angle (QRS-Ta), a non-invasive risk marker for arrhythmia and sudden cardiac death, captures information on the spatiotemporal dynamics of ventricular depolarization and repolarization. QRS-Ta peak is the angle between QRS and T-wave loop maximal amplitudes. We compared QRS-Ta peak with intra-cardiac unipolar electrocardiogram parameters simultaneously recorded in the right ventricle, left ventricle (LV) endocardium and LV epicardium (coronary sinus) in 10 patients with structurally normal hearts. S1S2 restitution protocols were performed by pacing from the LV at intervals decrementing from 1000 ms to the effective refractory period (ERP). Repolarization time (RT), activation time (AT) and activation-recovery interval (ARI), a standard surrogate for local action potential duration, were calculated using standard definitions. Decreasing cycle length (CL) correlated with an increase in QRS-Ta. Two phases were identified 1) A stable QRS-Ta between CLs 1000 to 400ms and 2) a subsequent rapid increase in QRSTa with further decrements and a small decrease in QRSTa just prior achieving ERP. When plotted against the pacing interval, the QRS-Ta distribution mirrored the repolarisation restitution curve. The QRS-T angle inversely correlated with mean RT (-0.59, -0.81 / -0.34, P=0.023) and mean ARI (-0.72, -0.73 / -0.42, P<0.02).

Type: Proceedings paper
Title: Comparisons of the Spatial QRS-T Angle with Intra-cardiac Markers of Depolarization and Repolarization
Event: 2020 Computing in Cardiology (CinC 2020)
Open access status: An open access version is available from UCL Discovery
DOI: 10.22489/CinC.2020.414
Publisher version: https://doi.org/10.22489/CinC.2020.414
Language: English
Additional information: This is an Open Access paper published under a Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/).
UCL classification: UCL
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 Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine > MRC Unit for Lifelong Hlth and Ageing
URI: https://discovery.ucl.ac.uk/id/eprint/10123261
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