Ventricular Transmural Dispersion Of Repolarization Predict Cardiac Resynchronization Therapy Deifbrillator Patients At Risk Of Ventricular Tachyarrhythmias

Objective: Comparing analysis of the preoperative and postoperativeelectrocardiographic marks about the QTc interval, TpTe, and TpTe/QTc whichresponsed myocardial transmural dispersion of repolarization (TDR) in cardiacresynchronization therapy defibrillator Patients whether need rapid treatment ofventricular arrhythmias associated.Methods:160cases Who implanted CRT-D in our hospital were enrolled in ourstudy.The data were preoperative electrocardiogram when the patients under the stablecondition and the immediate postoperative electrocardiogram,all data is selected toanalyze the ECG lead V5of the QTc interval, TpTe, TpTe/QTc ratio to assessedmyocardial TDR.All patients for routine follow-up were in our implanted CRT-Dcenter.Incidence of ventricular arrhythmias was determined based on routine anddirected device interrogations.Results: Appropriate CRT-D therapy for sustained ventricular tachycardia orventricular fibrillation was delivered in30patients (18.7%).1. Analysis the preoperative ECG results:Patients who received appropriateCRT-D therapy group had increased TpTe/QTc (0.22±0.06vs0.20±0.05, P＜0.01)and TpTe (107±24ms vs90±18ms P＜0.01) than did not receive CRT-D therapy group,but QTc interval was no significant difference (490±73ms vs466±65ms， P＞0.05).Increased QT interval was not associated with risk of ventricular arrhythmia.Which TpTe≥100ms and TpTe/QTc≥0.24can be considered acceptable CRT-Dtherapy significantly correlated.2.Analysis the postoperative ECG results:Patients who received appropriate CRT-D therapy group had increased TpTe/QTc (0.24±0.05vs0.20±0.04, P <0.001)and TpTe (119±30ms vs95±20ms, P <0.001) than did not receive CRT-D therapygroup, but QTc interval was no significant difference (480±60ms vs470±70ms, P=0.6). Increased QT interval was not associated with risk of ventricular arrhythmia.Which TpTe≥120ms and TpTe/QTc≥0.25can be considered acceptable CRT-Dtherapy significantly correlated.Conclusion: In preoperative and postoperative ECG Increased TpTe and increasedTpTe/QT ratio are associated with increased incidence of ventricular arrhythmias inCRT–D.