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QT interval dispersion analysis in patients undergoing left partial ventriculectomy (Batista operation)
Carlos Alberto Pastore1, Sandra Regina Arcêncio, Nancy M M O Tobias
1Heart Institute (InCor) of the University of São Paulo Medical School, São Paulo, Brazil. ecg_pastore@incor.usp.br
Background:
QT interval dispersion (QTd) has been valued as a marker of increased vulnerability for cardiac arrhythmias. QTd was analyzed in patients undergoing the left partial ventriculectomy (LPV) or Batista operation, a palliative surgery for patients in the line for heart transplantation, which is associated with complex arrhythmia and death from sustained ventricular tachyarrhythmia (SVT).
Methods:
Pre- and postoperative R-R, QT, QTc, JT (QT - QRS), and aT (apex to end of T wave) intervals were obtained by 87-lead body surface mapping from 24 patients (18 male), mean age 46.4 +/- 9.15 years. Dispersions of QT, QTc, JT, and aT intervals were calculated, and the total number of arrhythmic events were assessed, aiming to verify a possible risk predictor for the occurrence of SVTs. Subgroups of patients who survived and who died after LPV were also compared, aiming to obtain a QTd cutoff value that could be used prognostically.
Results:
No difference between pre- and postoperative mean values were found, but a very significant difference was seen when comparing QTd and QTcD values for surviving and dead patients: QTd, cutoff value was 95 ms, while QTcD value was 114 ms.
Conclusion:
There were no significant differences between pre- and postoperative variables or the number of arrhythmic events, but there were significant differences between both pre- and postoperative QTd and QTcD data from surviving and dead patients; this enabled the determination of cutoff values that we believe may be useful for the prognosis of the LPV outcome.