AI Article Synopsis
- ARVC patients experience exercise-related malignant arrhythmias due to delayed repolarization in the right ventricle (RV), which can be identified through autonomic interventions.
- A study involving 25-lead electrocardiograms measured QT intervals and TPE in nine ARVC patients and nine controls, revealing longer intervals in the RV for ARVC patients compared to controls.
- The Valsalva maneuver reversed the repolarization gradient in ARVC patients, indicating that this strain can change the repolarization pattern in the RV, potentially influencing arrhythmia risk.
Article Abstract
Objectives: Patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) experience exercise-related malignant arrhythmias possibly based on delayed repolarization in the diseased right ventricle (RV). Autonomic interventions might unveil repolarization abnormalities in RV.
Design: We recorded 25-lead electrocardiograms from nine symptomatic ARVC patients and nine controls during rest, Valsalva maneuver, mental stress, handgrip and supine exercise. Interventricular repolarization gradient was defined as difference of QT intervals between left ventricular (LV) and RV type leads. T-wave peak to T-wave end interval (TPE) was defined as the electrocardiographic (ECG) equivalent of transmural dispersion of repolarization.
Results: ARVC patients showed longer QT and TPE intervals in RV than in LV whereas control subjects showed the opposite. Valsalva strain reversed the interventricular repolarization gradient from -5+/-13 to 4+/-20 ms (p<0.02) and induced fluctuation of TPE in ARVC patients.
Conclusions: ARVC patients show ECG interventricular repolarization gradient from RV to LV and increased ECG transmural dispersion of repolarization in RV. Valsalva strain induces fluctuation of interventricular repolarization gradient and of transmural dispersion of repolarization in RV possibly modifying the substrate for arrhythmias.
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| http://dx.doi.org/10.1080/14017430802192337 | DOI Listing |
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