T-Wave Morphology Analysis in Congenital Long QT Syndrome Discriminates Patients From Healthy Individuals

JACC. Clinical Electrophysiology
Andreu Porta-SánchezDanna A Spears

Abstract

This study aims to assess the capability of T-wave analysis to: 1) identify genotype-positive long QT syndrome (LQTS) patients; 2) identify LQTS patients with borderline or normal QTc interval (≤460 ms); and 3) classify LQTS subtype. LQTS often presents with a nondiagnostic electrocardiogram (ECG). T-wave abnormalities may be the only marker of this potentially lethal arrhythmia syndrome. ECGs taken at rest in 108 patients (43 with LQTS1, 20 with LQTS2, and 45 control subjects) were evaluated for T-wave flatness, asymmetry, and notching, which produces a morphology combination score (MCS) of the 3 features (MCS = 1.6 × flatness + asymmetry + notch) using QT Guard Plus Software (GE Healthcare, Milwaukee, Wisconsin). To assess for heterogeneity of repolarization, the principal component analysis ratio 2 (PCA-2) was calculated. Mean QTc intervals were 486 ± 50 ms (LQTS1), 479 ± 36 ms (LQTS2), and 418 ± 24 ms (control subjects) (p < 0.05). MCS and PCA-2 differed between LQTS patients and control subjects (MCS: 117.8 ± 57.4 vs. 71.9 ± 16.2; p < 0.001; PCA-2: 20.2 ± 10.4% vs. 14.6 ± 5.5%; p < 0.001), LQTS1 and LQTS2 patients (MCS: 96.3 ± 28.7 vs. 164 ± 75.2; p < 0.001; PCA-2: 17.8 ± 8.3% vs. 25 ± 12.6%; p < 0.001), and between LQTS p...Continue Reading

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Citations

Jun 17, 2020·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Jens Cosedis NielsenChristophe Leclercq
Mar 3, 2019·Herzschrittmachertherapie & Elektrophysiologie·B BrüggemannC Zormpas
Jan 27, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Naoko NiimiKatherine Zaleski
Dec 16, 2020·International Journal of Cardiology·Jonas L IsaksenJørgen K Kanters
Feb 23, 2021·Frontiers in Cardiovascular Medicine·Gary TseWing Tak Wong

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