Non-dipolar content of the T-wave as a measure of repolarization inhomogeneity in ST-elevation myocardial infarction
2006 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 26, no 6, 362-370 p.Article in journal (Refereed) Published
The non-dipolar content of the T-wave, i.e. the component of the signal, which cannot be explained by a dipolar model, has been suggested as a measure of the local repolarization inhomogeneity. Our purpose was to study the non-dipolar content of the T-wave during the initial course of ST-elevation myocardial infarction (STEMI), when local repolarization inhomogeneity presumably is markedly increased. Twelve-lead ECG was semicontinuously collected in 211 patients with STEMI, treated with a thrombolytic agent. The T-wave was processed by principal component analysis. The absolute and relative T-wave residues were used as measures of the non-dipolar content. The median values for each hour and for the entire monitoring time were computed. Changes in the parameters were closer studied in two windows, 0-10 respectively, 11-24 h after start of ECG-monitoring. The median of the absolute T-wave residue during the entire monitoring period was 25 000 units in the STEMI-group and 13 500 units in the comparison group. The median for hour 1 was 36 500 units and 28 800 units for hour 2. The decrease was greater in patients with >or=50% resolution of the ST-elevation at 60 min. The moment of change, identified by cumulative sum-method, showed no correlation to the time for 50% ST-resolution. We conclude, that patients with thrombolysed STEMI have an increased non-dipolar content of the T-wave. Resolution of the ST-elevation is associated with a decrease. The increased non-dipolar content reflects a property of the repolarization phase, which is related to but separated from the ST-elevation.
Place, publisher, year, edition, pages
2006. Vol. 26, no 6, 362-370 p.
cumulative sum, non-dipolar components, principal component analysis, repolarization inhomogeneity, ST-elevation myocardial infarction, T-wave
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-24456DOI: 10.1111/j.1475-097X.2006.00701.xISI: 000241343500009PubMedID: 17042903OAI: oai:DiVA.org:uu-24456DiVA: diva2:52230