Prediction of drug-related morphological changes of the T wave.

• OBJECTIVES: To describe the characteristics of patients presenting with morphological T wave changes that lead to measurement difficulties, and to identify possible predictors of such changes at baseline and early after start of treatment. DESIGN: ECGs from 145 patients receiving a combined potassium and sodium channel blocking agent for conversion of atrial fibrillation (AF), underwent semiautomatic analysis in a digitalized high-precision analysis program. In 15 patients, one or more ECGs were identified as difficult to interpret due to morphological T wave changes. They were compared with the 130 patients without such changes. RESULTS: A history of cardiac failure (p=0.027), a smaller left atrial area (p=0.010) and a longer QT(tang) minus QT(top) interval (p<0.001) at baseline was significantly more frequent as compared to the controls. Identified patients also had somewhat longer baseline QT interval duration (median QT(cB) 432 vs. 408 ms, N.S.) and a larger proportion of them were females (47% vs. 27%, N.S.). After start of infusion the QT(cB) became significantly longer in identified patients than in controls (p=0.012). CONCLUSIONS: Independent predictors of subsequent morphological changes were found at baseline and shortly after start of treatment, and may be of use to identify individuals with a reduced repolarization reserve.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

Adult

Aged

Aged

80 and over

Anti-Arrhythmia Agents

administration & dosage

adverse effects

Arrhythmias

Cardiac

chemically induced

physiopathology

Atrial Fibrillation

drug therapy

physiopathology

Double-Blind Method

Electrocardiogram Pattern

Female

Heart Conduction System

drug effects

physiopathology

Humans

Infusions

Parenteral

Logistic Models

Male

Middle Aged

Organic Chemicals

administration & dosage

adverse effects

Potassium Channel Blockers

administration & dosage

adverse effects

Predictive Value of Tests

Risk Assessment

Risk Factors

Sodium Channel Blockers

administration & dosage

adverse effects

Sweden

Time Factors

Treatment Outcome

Young Adult

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)