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. 2021 Feb;35(2):e23636.
doi: 10.1002/jcla.23636. Epub 2020 Dec 17.

Tp-e and (Tp-e)/QT ratio as a non-invasive risk factors for malignant ventricular arrhythmia in patients with idiopathic ventricular premature complexes

Donghua Zhao  1 , Bo Liang  1 , Jian Peng  2 , Liangyu Tang  1 , Rongbin Su  1 , Lingli Luo  1 , Bin Deng  1 , Shuyuan Wang  1
Affiliations

Tp-e and (Tp-e)/QT ratio as a non-invasive risk factors for malignant ventricular arrhythmia in patients with idiopathic ventricular premature complexes

Donghua Zhao et al. J Clin Lab Anal. 2021 Feb.

Abstract

Background: To evaluate the role of Tp-e and (Tp-e)/QT ratio in differentiating benign ventricular premature complex (VPC) and malignant polymorphic ventricular tachycardia (PVT).

Methods: From January 2017 to December 2017, patients with documented polymorphic ventricular tachycardia (PVT) or ventricular fibrillation (VF) were consecutive included and classified as PVT/VF group. Sixty age- and sex-matched healthy individuals were recruited as comparative control and subdivided into non-VPC and VPC group. Clinical characteristics and Tp-e and Tp-e/QT ratio between the three groups were compared.

Results: Tp-e and (Tp-e)/QT ratio were significantly higher in patients of PVT/VF group compared with the other two groups (P < .001). Episodes of syncope were more frequent in patients with PVT/VF (P < .05). The sensitivity and specificity of a Tp-e interval ≥86 ms for malignant arrhythmias triggered by VPCs were 88% and 66%, respectively, while the sensitivity and specificity of the Tp-e/QT ratio ≥0.24 were 82% and 70%, respectively. Five patients complained recurrence of syncope in the PVT/VF group and 1 patient died with mean follow-up of 18 months.

Conclusion: Tp-e interval and the Tp-Te/QT ratio is significantly increased in patients with PVT/VF and may be used as a novel non-invasive marker of differentiating malignant and benign VPC.

Keywords: (Tp-e)/QT; Tp-e; ventricular fibrillation; ventricular premature complexes.

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Figures

FIGURE 1
FIGURE 1
Electrocardiogram. A, ECG representative example from the control group. Note that the Tp‐e was 61 ms; B, A representative example from the benign VPC pattern group. Note that the Tp‐e was 67 ms; C, A representative example from the PVT/VF group. Note that the Tp‐e was 116 ms; D, VF recorded by a monitoring ECG in a patient with the malignant form of idiopathic VT
FIGURE 2
FIGURE 2
ROC curves. Tp‐e (A) and Tp‐e/QT ratio (B) receiver‐operating characteristic (ROC) curve. The cut point was for Tp‐e values > 86 ms and Tp‐e/QT ratio > 0.24, respectively. The areas under the ROC curves were 0.83 for Tp‐e and 0.77 for Tp‐e/QT ratio
See this image and copyright information in PMC

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