Combination of QT variability and signal-averaged electrocardiography in association with ventricular tachycardia in postinfarction patients☆

The authors investigate incidence of ventricular tachycardia/ventricular fibrillation (VT/VF) in relationship with combination of noninvasive arrhythmia risk markers as left ventricular ejection fraction (LVEF), late potentials (LP), and QT variability index (QTVI) and compare the utility of their combination in association with sustained ventricular arrhythmias in patients after myocardial infarction (MI). Fifty-four patients with old MI, among them 27 with documented spontaneous sustained VT/VF entered the study. All of them underwent evaluation for arrhythmias and noninvasive risk stratificaton. Logistic regression analysis demonstrated that the highest association with ventricular tachyarrhythmia had combination of LP and increased QTVI (13.8, P<.0002), followed then by combination of LVEF and LP (12.2, P<.0005), LP alone (P<.001), QTVI (P<.002) and LVEF (P<.003) alone and age (P<.01). After stepwise regression analysis showed that the model including association of LP and QTVI, age and EF is the best one for delineating patients having the risk of ventricular tachyarrhythmia development. In conclusion, patients with combination of positive LP and increased QTVI after MI have high likelihood for development of serious sustained arrhythmia.