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Recovery Time Dispersion Measured from 87‐Lead Body Surface Potential Mapping as a Predictor of Sustained Ventricular Tachycardia in Patients with Idiopathic Dilated Cardiomyopathy
Author(s) -
AIBA TAKESHI,
INAGAKI MASASHI,
SHIMIZU WATARU,
MATSUO KIYOTAKA,
TAGUCHI ATSUSHI,
SUYAMA KAZUHIRO,
KURITA TAKASHT,
AIHARA NAOHIKO,
SUNAGAWA KENJI,
KAMAKURA SHIRO
Publication year - 2000
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2000.tb00168.x
Subject(s) - medicine , cardiology , dilated cardiomyopathy , lead (geology) , cardiomyopathy , body surface area , tachycardia , ventricular tachycardia , body surface , heart failure , geomorphology , geology , geometry , mathematics
Recovery Time Dispersion in DCM. Introduction : The clinical usefulness of QT dispersion in 12‐lead ECG has been controversial in identifying subjects at risk for sustained ventricular tachycardia (VT) in patients with idiopathic dilated cardiomyopathy (DCM). We hypothesized that increasing the spatial resolution of the ECG improves the accuracy of risk stratification. The purpose of this study was to test the ability of recovery time dispersion measured from 87‐lead body surface potential mapping (BSPM) to identify patients at risk for sustained VT in idiopathic DCM. Methods and Results : We obtained 87‐lead BSPM and 12‐lead ECG in 33 patients with idiopathic DCM (15 patients with a history of sustained VT [VT(+) group] and 18 patients without a history of sustained VT [VT(‐) group]) and in 20 normal control subjects. We measured the corrected QT dispersion and corrected recovery time dispersion from 12‐lead ECG (QTc‐12 dispersion and RTc‐12 dispersion, respectively) and 87‐lead BSPM (QTc‐87 dispersion and RTc‐87 dispersion, respectively). Signal‐averaged ECG also was recorded in 25 patients. Neither the QTc‐12 nor Qrc‐87 dispersion discriminated between the VT(+) and VT(‐) groups patients. The VT(+) group patients had a larger but insignificant RTc‐12 dispersion than the VT(‐) group patients. In contrast, the RTc‐87 dispersion was significantly larger in the VT(+) group patients than in the VT(‐) group patients (236 ± 39 msec vs 184 ± 28 msec, P < 0.001). Receiver operating curve analysis indicated that the RTc‐87 dispersion was as good as late potentials in predicting susceptibility to sustained VT; its sensitivity, specificity, and negative predictive value were 73%, 76%, and 76%, respectively (cutoff value 200 msec). RTc‐87 dispersion >200 msec combined with positive late potentials provide high sensitivity (92%) and high negative predictive value (88%) for sustained VT. Conclusion : The RTc‐87 dispersion is a useful tool to identify subjects at risk for sustained VT in patients with idiopathic DCM.