ECG-based estimation of dispersion of APD restitution as a tool to stratify sotalol-induced arrhythmic risk
A Mincholé1, A Bueno-Orovio1, P Laguna2
1Department of Computer Science, University of Oxford, Oxford, United Kingdom.
Background:
Increased spatial dispersion of restitution properties has been associated to arrhythmic risk. An ECG-based index quantifying restitution dispersion, DRest, is evaluated in patients who experienced Torsades de Pointes (TdP) under sotalol challenge and compared with the response in healthy subjects.
Methods And Results:
ECG recordings were analyzed for quantification of DRest and QTc, among others biomarkers. DRest provides improved discrimination following sotalol administration between TdP and healthy subjects ([min-max]: [0.18-0.22] vs [0.02-0.12]), compared to other biomarkers including QTc ([436-548ms] vs [376-467ms]). Results in healthy subjects are in agreement with simulations of sotalol effects on a human tissue electrophysiological model.
Conclusions:
This case study supports the potential of DRest for improved arrhythmia risk stratification even with QTc values below 450ms.
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