Related Experiment Video
Updated: Feb 10, 2026
Patient-specific Modeling of the Heart: Estimation of Ventricular Fiber Orientations
Published on: January 8, 2013
The Ventricular Ectopic QRS Interval: A Potential Marker for Ventricular Arrhythmia in Ischemic Heart Disease
Rachel Bastiaenen1, Hanney Gonna2, Navin Chandra3
1Department of Cardiology, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom; Institute of Cardiovascular and Cell Sciences, St. George's University of London, London, United Kingdom.
Insights
The ventricular ectopic QRS interval (VEQSI) effectively identifies patients with prior myocardial infarction and predicts life-threatening arrhythmias. A VEQSI max duration over 198 ms is a strong indicator of serious ventricular events in ischemic heart disease patients.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac diagnostics
Background:
- Risk stratification for sudden death in ischemic heart disease (IHD) remains challenging.
- The ventricular ectopic QRS interval (VEQSI) is a known marker for structural heart disease and mortality.
- Hypothesized VEQSI identifies post-myocardial infarction (MI) patients and distinguishes those with life-threatening ventricular arrhythmias.
Purpose of the Study:
- To evaluate the novel marker VEQSI for assessing structural heart disease severity.
- To determine the potential of VEQSI in predicting arrhythmia risk in IHD patients.
Main Methods:
- Analyzed 12-lead Holter recordings from 189 post-MI patients (38 with prior VT/VF, 151 without) and 60 healthy controls.
- Measured maximal VEQSI duration (VEQSI max) from ventricular ectopic beats.
- Compared VEQSI max between groups: MI-VT/VF, MI-no VT/VF, and healthy controls.
Main Results:
- VEQSI max was significantly longer in post-MI patients versus controls (185 ± 26 ms vs. 164 ± 16 ms).
- MI-VT/VF patients had a longer VEQSI max than MI-no VT/VF patients (214 ± 20 ms vs. 177 ± 22 ms).
- VEQSI max >198 ms demonstrated 86% sensitivity and 85% specificity for identifying prior life-threatening events, with an odds ratio of 37.4.
Conclusions:
- Maximal VEQSI duration >198 ms effectively distinguishes post-MI patients with a history of life-threatening arrhythmias.
- VEQSI max serves as a valuable additional index for risk stratification in patients with IHD.
Objectives:
The purpose of this study was to determine the potential value of a novel marker for the severity of structural heart disease and the risk of arrhythmia.
Background:
The ventricular ectopic QRS interval (VEQSI) has been shown to identify structural heart disease and predict mortality in an unselected population. In ischemic heart disease (IHD), risk stratification for sudden death is imperfect. We hypothesized that VEQSI would identify patients with prior myocardial infarction (MI) compared with healthy subjects and distinguish IHD patients who have suffered life-threatening events from those without prior significant ventricular arrhythmia.
Methods:
The 12-lead Holter recordings from 189 patients with previous MI were analyzed: 38 with prior ventricular tachycardia/ventricular fibrillation (MI-VT/VF) (66 ± 9 years; 92% male); 151 without prior significant ventricular arrhythmia (MI-no VT/VF) (64 ± 11 years; 74% male). These were compared with 60 healthy controls (62 ± 7 years; 70% male). All ventricular ectopic beats were reviewed and maximal VEQSI duration (VESQI max) was recorded as the duration of the longest ventricular ectopic beat.
Results:
VEQSI max was longer in post-MI patients compared with normal controls (185 ± 26 ms vs. 164 ± 16 ms; p < 0.001) and in MI-VT/VF patients with prior life-threatening events compared with MI-no VT/VF patients without prior life-threatening events (214 ± 20 ms vs. 177 ± 22 ms; p < 0.001). Multivariate analysis established VEQSI max as the strongest independent marker for prior serious ventricular arrhythmia. VEQSI max >198 ms had 86% sensitivity, 85% specificity, 62% positive predictive value, and 96% negative predictive value for identifying patients with prior life-threatening events (odds ratio: 37.4; 95% confidence interval: 13.0 to 107.5).
Conclusions:
VEQSI max >198 ms distinguishes post-MI patients with prior life-threatening events from those without prior significant ventricular arrhythmia. This may be a useful additional index for risk stratification in IHD.
More Related Videos
09:36Dual-Dye Optical Mapping of Hearts from RyR2R2474S Knock-In Mice of Catecholaminergic Polymorphic Ventricular Tachycardia
Published on: December 22, 2023
06:57Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
Published on: January 31, 2019
Related Concept Videos
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
01:27Anatomy of the Heart
01:16ECG Interpretation of Arrhythmias I: Sinus Arrhythmias
Types of Arrhythmias
Sinus Node Arrhythmias
Sinus Bradycardia: Originating from the sinoatrial (SA) node, sinus bradycardia involves slower impulses, resulting in a heart rate of less than 60 beats per minute (bpm). Causes include sleep, vagal stimulation, beta-blockers, hypothyroidism,...
01:23Rheumatic Heart Disease I: Introduction
01:03Prediction Intervals
However, the point estimate is most likely not the exact value of the population parameter, but close to it. After calculating point estimates, we construct interval estimates, called confidence intervals or prediction intervals. This prediction interval comprises a range of values unlike the point estimate and is a better predictor of the observed sample value, y.