QRS duration and dispersion for predicting ventricular arrhythmias in early stage of acute myocardial infraction

Chávez‐González, E.L.; Jiménez, A.E. Rodríguez; Moreno-Martínez, Francisco L.

doi:10.1016/j.medine.2017.04.003

Cited by 12 publications

(10 citation statements)

References 29 publications

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“…QRS dispersion is defined as the difference between the maximum and minimum QRS duration measured in the standard twelve lead ECG. It has been suggested that an increased QRS dispersion (QRSd) is a marker of inhomogeneous ventricular depolarization and could be associated with negative prognosis (1).…”

Section: Introductionmentioning

confidence: 99%

Is there a utility for QRS dispersion in clinical practice?

Donoiu¹,

Târtea²,

Chávez-González³

2017

J Mind Med Sci.

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Keywords: 12-lead electrocardiogram, cardiomyopathy and heart failure, myocardial infarction. AbstractPrognostic markers derived from standard ECG have always been seductive.Increased dispersion of durations of the P wave, of the QRS complex, or of the QT interval has been associated with the risk of atrial fibrillation, ventricular arrhythmias, sudden cardiac death, as well as with a general negative prognosis in various settings.However, these markers have intrinsic and methodological issues that question their utility. This paper presents data supporting the utility of QRS dispersion in clinical practice. Our investigation shows that QRS dispersion is a simple electrocardiographic marker with potential value in the assessment of patients in a variety of clinical settings: ischemic heart disease, heart failure, and cardiomyopathies.More studies are needed to validate QRS clinical utility for predicting the risk for ventricular arrhythmias and sudden cardiac death, and for the evaluation of the response to cardiac resynchronization therapy.Acne conglobata is a rare, severe form of acne vulgaris characterized by the presence of comedones, papules, pustules, nodules and sometimes hematic or meliceric crusts, located on the face, trunk, neck, arms and buttocks.Ionuț Donoiu et al. 133

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Section: Introductionmentioning

confidence: 99%

Is there a utility for QRS dispersion in clinical practice?

Donoiu¹,

Târtea²,

Chávez-González³

2017

J Mind Med Sci.

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“…It is difficult to explain the significance and implications of this finding. Previous studies have demonstrated that the duration and dispersion of the QRS were higher in the ECG leads showing acute ischaemias, suggesting that that the odds of ventricular arrhythmias during the occurrence of an acute myocardial infarction are much higher when the duration and dispersion of the QRS are higher [28,29].…”

Section: Discussionmentioning

confidence: 95%

“…A total of 128 subjects were recruited for the study. The participants consist of two groups; a young age group of 62 persons (aged [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35]) and an elderly group (66 in number aged 60-89). The young volunteers were made of students, hospital workers as well as members of the local community.…”

Section: Methodsmentioning

confidence: 99%

Determinants of Spatial Dispersion of P-Wave, QRS Complex, and QT-Interval on 12-Lead Electrocardiogram in Apparently Healthy Adults

Nelson¹,

U²,

C³

et al. 2021

Int J Clin Cardiol

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Background:The spatial dispersion of P-wave, QRS complex, and QT interval on 12-lead electrocardiogram are related to the electrical instability in cardiac conducting tissues and elevated parameters are associated with increased risk of cardiovascular morbidity and mortality. Objectives:We sought to evaluate the dispersion of P-wave, QRS complex, and QT interval in healthy adult Nigerians and assess their relationship to age, gender, anthropometric and some physiologic parameters.Methods: A total of 128 subjects were recruited for the study. The participants consist of two groups; a young age group of 62 apparently healthy individuals (aged 18-35 years) and an elderly age group of 66 participants (aged 60-89 years) drawn from attendees to the quarterly medical lectures of the Ebreime Foundation for the Elderly, a non-Governmental organization. The exclusion criteria for the study were presence of acute or chronic illnesses and medications capable of affecting electrocardiogram. All subjects had background medical history assessment, clinical examination and resting 12-lead electrocardiography. The dispersion of P-wave, QRS and QT intervals were measured manually under magnifying glass by one observer and were taken as the difference between the maximum and minimum values of each parameter on standard 12lead electrocardiogram. Results:The elderly subjects had significantly higher body mass index compared to the young subjects. Blood pressure indices were comparable in the two groups. The dispersions of P-wave, QRS and QT on 12-lead electrocardiography were all significantly increased in the elderly. Significant gender variations were noted in QRS dispersion, QTc interval and QT dispersion which were all significantly increased in women. A significant correlation was noted between QT dispersion and body mass index (r = 0.280; p = 0.023). Conclusion:Age, gender and body mass index are significant determinants of P-wave, QRS, and QT dispersion in the adult population. Identification of high risk individuals for cardiovascular disease for prompt preventive intervention is of prime importance.

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“…The findings of the vectorcardiography analysis can be discussed from different perspectives. First, a previous study has proposed that QRS dispersion is related to the electrophysiological conduction of the myocardium; thus, more significant dispersion will lead to more VAs [ 22 ]. In our study, the SCD group had a lower regularity of the QRS loop descriptors than the control group.…”

Section: Discussionmentioning

confidence: 99%

Using QRS loop descriptors to characterize the risk of sudden cardiac death in patients with structurally normal hearts

Lin

Lee

et al. 2022

PLoS ONE

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The predictive value of non-invasive electrocardiographic examination findings for the risk of sudden cardiac death (SCD) in populations with structurally normal hearts remains unclear. This study aimed to investigate the characteristics of the QRS vectorcardiography of surface electrocardiography in patients with structurally normal hearts who experienced SCD. We consecutively enrolled patients who underwent vectorcardiography between March 2017 and December 2018 in a tertiary referral medical center. These patients didn’t have structural heart diseases, histories of congestive heart failure, or reduced ejection fraction, and they were classified into SCD (with aborted SCD history and cerebral performance category score of 1) and control groups (with an intervention for atrioventricular node reentrant tachycardia and without SCD history). A total of 162 patients (mean age, 54.3±18.1 years; men, 75.9%), including 59 in the SCD group and 103 in the control group, underwent propensity analysis. The baseline demographic variables, underlying diseases, QRS loop descriptors (the percentage of the loop area, loop dispersion, and inter-lead QRS dispersion), and other electrocardiographic parameters were compared between the two groups. In the univariate and multivariate analyses, a smaller percentage of the loop area (odds ratio, 0.0003; 95% confidence interval, 0.00–0.02; p<0.001), more significant V4-5 dispersion (odds ratio, 1.04; 95% confidence interval, 1.02–1.07; p = 0.002), and longer QRS duration (odds ratio, 1.05; 95% confidence interval, 1.00–1.10; p = 0.04) were associated with SCD. In conclusion, the QRS loop descriptors of surface electrocardiography could be used as non-invasive markers to identify patients experiencing aborted SCD from a healthy population. A decreased percentage of loop area and elevated V4-5 QRS dispersion values assessed using vectorcardiography were associated with an increased risk of SCD in patients with structurally normal hearts.

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QRS duration and dispersion for predicting ventricular arrhythmias in early stage of acute myocardial infraction

Cited by 12 publications

References 29 publications

Is there a utility for QRS dispersion in clinical practice?

Is there a utility for QRS dispersion in clinical practice?

Determinants of Spatial Dispersion of P-Wave, QRS Complex, and QT-Interval on 12-Lead Electrocardiogram in Apparently Healthy Adults

Using QRS loop descriptors to characterize the risk of sudden cardiac death in patients with structurally normal hearts

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