ASSESSMENT OF NON-INVASIVE MARKERS IN IDENTIFYING PATIENTS AT RISK OF INDUCIBLE VENTRICULAR ARRHYTHMIAS
Background: A number of non-invasive tools have been tested to assess arrhythmogenic risk in different patients groups. Some of them could possibly predict the inducibility of ventricular tachycardia (VT) by programmed ventricular stimulation (PVS). Methods: The study has been conducted at Al-Kadhimia Teaching Hospital, Baghdad/Iraq.26 patients suspected to have ventricular arrhythmias as underlying cause to their symptoms and planned for PVS were included between May 2004 to December 2005. In one patient electrophysiologic (EP) study could not be performed because he was in slow well tolerated VT and thus was omitted from the study. QRS-dispersion (QRSd), QT-dispersion (QTd), short-term heart rate variability (HRV) and heart rate turbulence (HRT) were measured in all the 25 patients prior to their admission for PVS. The patients were divided in 2 groups according to the result of the invasive EP study: Group I (n=17) included the patients in whom ventricular arrhythmia (VA) couldnâ€™t be induced by PVS. Group II (n=8) included the patients in whom sustained VA was induced by PVS. Results: A higher mean QRSd, QTd and QRSd+QTd was found in group II in comparison with Group I. A significant difference was noticed in mean QRSd and QRSd+QTd (p=0.038 and 0.0167 respectively) but not in QTd (p=0.161). A significant difference between the two groups was noticed in mean short-term HRV (p=0.014). Mean turbulence onset (TO) value was higher (p=0.014) and mean turbulence slope (TS) value were lower (p=0.544) in Group II, but the difference was significant only in mean TO. Conclusion: QRS dispersion, short-term heart rate variability and turbulence onset may be important risk stratifying parameters regarding arrythmogenic liability.
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