Int J Arrhythm.  2016 Dec;17(4):174-180. 10.18501/arrhythmia.2016.030.

Time Variance of Electrocardiographic Transmural Dispersion in Acute Myocardial Infarction

• Park JS
• Hwang GS
• Kim SM
• Seo KW
• Choi BJ
• Choi SY
• Yoon MH
• Shin JH
• Tahk SJ

• KMID: 2366164
• DOI: http://doi.org/10.18501/arrhythmia.2016.030

Abstract

BACKGROUND AND OBJECTIVES
The mechanism responsible for lethal ventricular arrhythmia (LVA) after acute myocardial infarction (AMI) remains unclear.
SUBJECTS AND METHODS
The corrected QT interval (QTc) and interval from the peak to the end of the T wave (TpTe) were measured, which indicated myocardial transmural dispersion of repolarization (TDR) in 72 patients with AMI. TpTe was also expressed as a corrected value, [TpTe/QTe]x100% and TpTe/√RR. These parameters were obtained from all the 12-leads of electrocardiography after arrival at the hospital, just before and after percutaneous coronary intervention (PCI), and at 4, 24, and 48 hours and 5 days after PCI.
RESULTS
Analyzing with repeated measures analysis of variance, the TpTe, [TpTe/QTe]x100% and TpTe/√RR after AMI showed significant changes in time variance. The patients were divided into LVA (17 patients, 24%) and non-LVA group (55 patients, 76%). The [TpTe/ QTe]×100% (Vâ‚‚: 25±7% vs. 22±5%, p=0.036) and TpTe/√RR (Vâ‚‚: 109 ± 42 ms vs. 88 ± 22 ms, p=0.05, V₃: 108±39 ms vs. 91±27 ms, p=0.048) in Vâ‚‚ and V₃ leads were prolonged in the LVA group after PCI. The [TpTe/QTe]×100% (28±9 % vs. 22±5%, p=0.025) and TpTe/√RR (129±53 ms vs. 99±41 ms, p=0.05) in V₃ lead were prolonged in the LVA group 24 hours after PCI.
CONCLUSION
The mechanisms responsible for LVA after AMI may be associated with increased TDR, and PCI may have an important role in reducing LVA.

Keyword

Myocardial Infarction; Cardiac Arrhythmia

MeSH Terms

Arrhythmias, Cardiac
Electrocardiography*
Humans
Myocardial Infarction*
Percutaneous Coronary Intervention