Traditional and novel electrocardiographic conduction and repolarization markers of sudden cardiac death
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摘要Sudden cardiac death, frequently due to ventricular arrhythmias, is a significant problem globally. Most affected individuals do not arrive at hospital in time for medical treatment. Therefore, there is an urgent need to identify the most-at-risk patients for insertion of prophylactic implantable cardioverter defibrillators. Clinical risk markers derived from electrocardiography are important for this purpose. They can be based on repolarization, including corrected QT (QTc) interval, QT dispersion (QTD), interval from the peak to the end of the T-wave (Tpeak – Tend), (Tpeak – Tend)/QT, T-wave alternans (TWA), and microvolt TWA. Abnormal repolarization properties can increase the risk of triggered activity and re-entrant arrhythmias. Other risk markers are based solely on conduction, such as QRS duration (QRSd), which is a surrogate marker of conduction velocity (CV) and QRS dispersion (QRSD) reflecting CV dispersion. Conduction abnormalities in the form of reduced CV, unidirectional block, together with a functional or a structural obstacle, are conditions required for circus-type or spiral wave re-entry. Conduction and repolarization can be represented by a single parameter, excitation wavelength (λ = CV × effective refractory period). λ is an important determinant of arrhythmogenesis in different settings. Novel conduction–repolarization markers incorporating λ include Lu et al.' index of cardiac electrophysiological balance (iCEB: QT/QRSd), [QRSD× (Tpeak − Tend)/QRSd] and [QRSD × (Tpeak − Tend)/(QRSd × QT)] recently proposed by Tse and Yan. The aim of this review is to provide up to date information on traditional and novel markers and discuss their utility and downfalls for risk stratification.
著者Tse G, Yan BP
期刊名稱EP-Europace
出版年份2017
月份5
日期1
卷號19
期次5
出版社Oxford University Press
頁次712 - 721
國際標準期刊號1099-5129
電子國際標準期刊號1532-2092
語言英式英語
關鍵詞Cardiac arrhythmia, Repolarization, Conduction, Depolarization, Dispersion, Risk stratification, Sudden cardiac death

上次更新時間 2020-20-11 於 02:41