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Related Experiment Videos

Extrasystolic beats affect transmural electrical dispersion during programmed electrical stimulation.

R Wolk1, S Stec, P Kulakowski

  • 1Postgraduate Medical School, Warsaw, Poland. r_wolk@hotmail.com

European Journal of Clinical Investigation
|April 12, 2001
PubMed
Summary

The Tpeak-Tend (TpTe) interval may indicate transmural dispersion of repolarization (TDR). A longer maximum TpTe interval during ventricular pacing suggests increased TDR and is linked to inducible arrhythmias in patients.

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Repolarization

Background:

  • Experimental studies link the electrocardiographic Tpeak-Tend (TpTe) interval to transmural dispersion of repolarization (TDR).
  • The clinical significance and pro-arrhythmic role of the TpTe interval remain to be established.

Purpose of the Study:

  • To evaluate the clinical utility of the TpTe interval as an index of TDR.
  • To assess the TpTe interval as a potential marker for pro-arrhythmic risk.

Main Methods:

  • Assessed endocardial monophasic action potential (MAP) duration and ECG intervals (QTp, QTe, TpTe) in 13 patients during electrophysiological studies.
  • Recorded surface ECGs during right ventricular pacing and premature stimulation.

Main Results:

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  • Ventricular arrhythmias were induced in 6 out of 13 patients.
  • Premature stimulation altered MAP duration, QTp, and QTe intervals, indicating changes in repolarization.
  • The TpTe interval was significantly greater in patients with inducible arrhythmias, both at baseline and after premature stimulation.

Conclusions:

  • The surface ECG Tpeak-Tend (TpTe) interval likely reflects transmural dispersion of repolarization (TDR).
  • Premature ventricular stimulation increases TDR, as suggested by TpTe interval prolongation.
  • A greater maximum TpTe interval during ventricular pacing is associated with inducible arrhythmias, suggesting its potential as a pro-arrhythmic marker.