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.

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
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

Aunes-Jansson, Maria (författare)
Samuelsson, Emma (författare)
Frison, Lars (författare)
Johansson, S (författare)
Berggren, Anders (författare)
Edvardsson, Nils,1942Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xedvni (författare)
Göteborgs universitetInstitutionen för medicin, avdelningen för molekylär och klinisk medicin (creator_code:org_t)

Ingår i:Scandinavian cardiovascular journal : SCJ: Informa UK Limited44:4, s. 215-221651-20061401-7431

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kardiologi

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