QT Dispersion: Problems of Methodology and Clinical Significance

QT Dispersion. QT dispersion is defined as the difference in QT interval between the different leads of the surface 12‐lead ECG. This may provide an indirect measure of the underlying inhomogeneity of myocardial repolarization, which is believed to be important in arrhylhmogenesis. Methodology for determining QT dispersion varies significantly between studies, and the results of these studies need to be interpreted in light of the methodology used. Although QT dispersion is developing into an important research tool, as yet it has no established role in clinical practice. Once standardization of methodology is achieved a clinical role may emerge, particularly in the assessment of patients before and after intervention aimed at reduction of arrhythmia risk.

[1]  B. Surawicz,et al.  The Measurement of the Q‐T Interval of the Electrocardiogram , 1952, Circulation.

[2]  V. Bonatti,et al.  Recording of monophasic action potentials of the right ventricle in long QT syndromes complicated by severe ventricular arrhythmias. , 1983, European heart journal.

[3]  T. Butler,et al.  QT prolongation and sudden cardiac death in patients with alcoholic liver disease , 1993, The Lancet.

[4]  J. Mccomb,et al.  QT dispersion in sinus beats and ventricular extrasystoles in normal hearts. , 1992, British heart journal.

[5]  B. Surawicz Electrophysiologic substrate of torsade de pointes: dispersion of repolarization or early afterdepolarizations? , 1989, Journal of the American College of Cardiology.

[6]  D. Mirvis,et al.  Spatial variation of QT intervals in normal persons and patients with acute myocardial infarction. , 1985, Journal of the American College of Cardiology.

[7]  P. Nihoyannopoulos,et al.  QT‐interval abnormalities in hypertrophic cardiomyopathy , 1992, Clinical cardiology.

[8]  L. M. Taran,et al.  The duration of the electrical systole, Q-T, in acute rheumatic carditis in children. , 1947, American heart journal.

[9]  Jeffrey L. Anderson,et al.  Reduction in QT Interval Dispersion by Successful Thrombolytic Therapy in Acute Myocardial Infarction , 1994, Circulation.

[10]  A J Camm,et al.  Adjustment of QT dispersion assessed from 12 lead electrocardiograms for different numbers of analysed electrocardiographic leads: comparison of stability of different methods. , 1994, British heart journal.

[11]  A. Camm,et al.  Assessment of QT dispersion in symptomatic patients with congenital long QT syndromes. , 1992, The American journal of cardiology.

[12]  J. Matthews,et al.  Reduction in QT dispersion by sotalol following myocardial infarction. , 1991, European heart journal.

[13]  Craig D. Miller,et al.  Management of Patients With Intramural Hematoma of the Thoracic Aorta , 1993, Circulation.

[14]  J. Mccomb,et al.  QT dispersion: an indication of arrhythmia risk in patients with long QT intervals. , 1990, British heart journal.

[15]  J. Bourke,et al.  Importance of lead selection in QT interval measurement. , 1988, The American journal of cardiology.

[16]  G. Buja Short- and long-term reproducibility of QT, QTc, and QT dispersion measurement in healthy subjects. , 1994, Pacing and clinical electrophysiology : PACE.

[17]  P. Schwartz,et al.  Mapping of body surface potentials in patients with the idiopathic long QT syndrome. , 1986, Circulation.

[18]  Hc. Bazett An analysis of the time relationships of the heart , 1920 .

[19]  P. Davey,et al.  QT interval dispersion in chronic heart failure and left ventricular hypertrophy: relation to autonomic nervous system and Holter tape abnormalities. , 1994, British heart journal.

[20]  B. Surawicz,et al.  Characteristics and Possible Mechanism of Ventricular Arrhythmia Dependent on the Dispersion of Action Potential Durations , 1983, Circulation.

[21]  G. Schuler,et al.  Regular Physical Exercise and Low‐Fat Diet: Effects on Progression of Coronary Artery Disease , 1992, Circulation.

[22]  P. Schwartz,et al.  Dispersion of ventricular repolarization in the long QT syndrome. , 1991, The American journal of cardiology.

[23]  C. Lang,et al.  QT dispersion and sudden unexpected death in chronic heart failure , 1994, The Lancet.

[24]  D. T. Kaplan,et al.  Repolarization Inhomogeneities in Ventricular Myocardium Change Dynamically With Abrupt Cycle Length Shortening , 1991, Circulation.

[25]  D. Wyse,et al.  Precordial QT Interval Dispersion as a Marker of Torsade de Pointes: Disparate Effects of Class Ta Antiarrhythmic Drugs and Amiodarone , 1992, Circulation.

[26]  M. Stanton,et al.  Regional sympathetic denervation after myocardial infarction in humans detected noninvasively using I-123-metaiodobenzylguanidine. , 1989, Journal of the American College of Cardiology.

[27]  H. Bazett,et al.  AN ANALYSIS OF THE TIME‐RELATIONS OF ELECTROCARDIOGRAMS. , 1997 .

[28]  J. .. Abildskov,et al.  The recognition of arrhythmia vulnerability by body surface electrocardiographic mapping. , 1987, Circulation.

[29]  S. Cobbe,et al.  Effects of the class III antiarrhythmic drug dofetilide on ventricular monophasic action potential duration and QT interval dispersion in stable angina pectoris. , 1992, The American journal of cardiology.

[30]  E. R. Smith,et al.  Vulnerability to ventricular arrhythmia: assessment by mapping of body surface potential. , 1986, Circulation.