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. 2025 Apr 14.
doi: 10.1007/s00392-025-02648-x. Online ahead of print.

Tpeak-Tend interval predicts arrhythmia recurrence in idiopathic ventricular fibrillation and early repolarization syndrome

Benjamin Rath  1 , Julian Wolfes  2 , Christian Ellermann  2 , Fatih Güner  2 , Felix Wegner  2 , Julia Köbe  2 , Florian Reinke  2 , Philipp Sebastian Lange  2 , Gerrit Frommeyer  2 , Lars Eckardt  2
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Tpeak-Tend interval predicts arrhythmia recurrence in idiopathic ventricular fibrillation and early repolarization syndrome

Benjamin Rath et al. Clin Res Cardiol. .

Abstract

Background: In about 8% of survivors of sudden cardiac death, no structural or electrical heart disease can be identified. Some of these patients with idiopathic ventricular fibrillation (IVF) present ECG markers of early repolarization (Early Repolarization Syndrome, ERS). The Tpeak-Tend interval has been linked to increased arrhythmic risk in different clinical settings, such as Brugada syndrome or hypertrophic cardiomyopathy. As there is limited data about the relationship of Tpeak-Tend and arrhythmogenesis in IVF, respectively, its significance in risk stratification in ERS, the aim of this study was to investigate a possible correlation between sustained ventricular arrhythmia (VA) recurrences in these patients and the Tpeak-Tend interval.

Methods and results: We retrospectively investigated 56 consecutive IVF patients (64.3% male, mean age 37.8 ± 12.9 years) who received an implantable cardioverter-defibrillator for secondary prevention. Markers of early repolarization were present in 32.1% of cases. During a mean follow-up of 41.2 ± 35.8 months, 11 patients (19.6%) received in total 18 adequate ICD-therapies. Patients with VA recurrence showed longer Tpeak-Tend compared to arrhythmia-free patients (105 ± 14 ms vs. 91 ± 14 ms, p = 0.03). The combination of prolonged Tpeak-Tend (> 90 ms) and an early repolarization pattern was associated with a 12-fold increased risk of recurrent VA (p = 0.002).

Conclusion: Prolonged Tpeak-Tend was associated with VA recurrence in patients with survived IVF. This correlation was even more pronounced in IVF patients with early repolarization pattern. The Tpeak-Tend interval might play a future role in risk stratification of patients with ERS.

Keywords: T peak–T end; Early repolarization Syndrome; Idiopathic ventricular fibrillation.

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Conflict of interest statement

Declarations. Conflict of interest: The authors report no relationships that could be construed as a conflict of interest.

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