The relation between local repolarization and T-wave morphology in heart failure patients
POTSE, Mark
Modélisation et calculs pour l'électrophysiologie cardiaque [CARMEN]
IHU-LIRYC
Center for Computational Medicine in Cardiology [Lugano]
See more >
Modélisation et calculs pour l'électrophysiologie cardiaque [CARMEN]
IHU-LIRYC
Center for Computational Medicine in Cardiology [Lugano]
POTSE, Mark
Modélisation et calculs pour l'électrophysiologie cardiaque [CARMEN]
IHU-LIRYC
Center for Computational Medicine in Cardiology [Lugano]
Modélisation et calculs pour l'électrophysiologie cardiaque [CARMEN]
IHU-LIRYC
Center for Computational Medicine in Cardiology [Lugano]
ILLNER, Annekatrin
Otto-von-Guericke-Universität Magdeburg = Otto-von-Guericke University [Magdeburg] [OVGU]
Cardiocentro Ticino [Lugano]
Otto-von-Guericke-Universität Magdeburg = Otto-von-Guericke University [Magdeburg] [OVGU]
Cardiocentro Ticino [Lugano]
AURICCHIO, Angelo
Cardiocentro Ticino [Lugano]
Center for Computational Medicine in Cardiology [Lugano]
< Reduce
Cardiocentro Ticino [Lugano]
Center for Computational Medicine in Cardiology [Lugano]
Language
en
Article de revue
This item was published in
International Journal of Cardiology. 2017-02-22, vol. 241, p. 270 - 276
Elsevier
English Abstract
Background: Both duration and morphology of the T-wave are regarded important parameters describing repo-larization of the ventricles. Conventionally, T-wave concordance is explained by an inverse relation between the time ...Read more >
Background: Both duration and morphology of the T-wave are regarded important parameters describing repo-larization of the ventricles. Conventionally, T-wave concordance is explained by an inverse relation between the time of depolarization (TD) and repolarization (TR). Little is known about T-wave morphology and TD-TR relations in patients with heart failure. Methods: Electro-anatomic maps were obtained in the left (LV) and right ventricle (RV) and in the coronary sinus (CS) in patients with heart failure with narrow (nQRS, n = 8) and wide QRS complex with (LBBB, n = 15) and without left bundle branch block (non-LBBB, n = 7). TD and TR were determined from the thus acquired electro-grams. Results: In nQRS and non-LBBB patients, TD-TR relations had a slope between 0 and +1, indicating that repolar-ization followed the sequence of depolarization. In LBBB patients, repolarization occurred significantly earlier in the RV than in the LV, fitting with the idea that the discordant T-waves in LBBB are secondary to the abnormal depolarization sequence. However, the slopes of the TD-TR relations in the LV and CS were not significantly different from zero, indicating no major spatial gradient in LV repolarization, despite a considerable gradient in de-polarization. Remarkable was also the large (~100 ms) transseptal gradient in repolarization. Values of the slopes of the TD-TR relation overlapped between the three patient groups, despite a difference in T-wave morphology between LBBB (all discordant) and nQRS patients (all flat/biphasic). Conclusions: Discordant T-waves in LBBB patients are explained by interventricular dispersion in repolarization. T-wave morphology is determined by more factors than the TD-TR relation alone.Read less <
English Keywords
Heart failure
Left bundle branch block
Repolarization
T-wave
Electro-anatomic mapping
Origin
Hal imported