ECG-based estimation of dispersion of APD restitution as a tool to stratify sotalol-induced arrhythmic risk.

Abstract

BACKGROUND:

Increased spatial dispersion of restitution properties has been associated to arrhythmic risk. An ECG-based index quantifying restitution dispersion, DRest, is evaluated in patients who experienced Torsades de Pointes (TdP) under sotalol challenge and compared with the response in healthy subjects.

METHODS AND RESULTS:

ECG recordings were analyzed for quantification of DRest and QTc, among others biomarkers. DRest provides improved discrimination following sotalol administration between TdP and healthy subjects ([min-max]: [0.18-0.22] vs [0.02-0.12]), compared to other biomarkers including QTc ([436-548ms] vs [376-467ms]). Results in healthy subjects are in agreement with simulations of sotalol effects on a human tissue electrophysiological model.

CONCLUSIONS:

This case study supports the potential of DRest for improved arrhythmia risk stratification even with QTc values below 450ms.

• Authors: A Mincholé, A Bueno-Orovio, P Laguna, E Pueyo, B Rodriguez
• Journal: Journal of electrocardiology (J Electrocardiol) 2015 Sep-Oct Vol. 48 Issue 5 Pg. 867-73 ISSN: 1532-8430 [Electronic] United States
• PMID: 26117457 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015. Published by Elsevier Inc.

Chemical References

• Anti-Arrhythmia Agents
• Sotalol

Topics

• Anti-Arrhythmia Agents (adverse effects)
• Diagnosis, Computer-Assisted (methods)
• Electrocardiography (methods)
• Humans
• Reproducibility of Results
• Risk Assessment (methods)
• Sensitivity and Specificity
• Sotalol (adverse effects)
• Torsades de Pointes (chemically induced, diagnosis, prevention & control)
• Treatment Outcome