Emerging evidence for a mechanistic link between low-frequency oscillation of ventricular repolarization measured from the electrocardiogram T-wave vector and arrhythmia

Peter Taggart; Esther Pueyo; Stefan van Duijvenboden; Bradley Porter; Martin Bishop; David A Sampedro-Puente; M Orini; B Hanson; Christopher A Rinaldi; Jaswinder S Gill; Pier Lambiase

doi:10.1093/europace/euab009

Emerging evidence for a mechanistic link between low-frequency oscillation of ventricular repolarization measured from the electrocardiogram T-wave vector and arrhythmia

Europace. 2021 Sep 8;23(9):1350-1358. doi: 10.1093/europace/euab009.

Authors

Affiliations

¹ Department of Cardiovascular Sciences, University College London, London, UK.
² BSICOS Group, 13A, 11S, Aragon, University of Zaragoza, Spain.
³ CIBER-BBN, Zaragoza, Spain.
⁴ Department of Imaging Sciences and Biomedical Engineering, KCL, London, UK.
⁵ UCL Mechanical Engineering, University College London, London, UK.
⁶ Cardiology Department, Guys and St Thomas' Hospital, London, UK.

Abstract

Strong recent clinical evidence links the presence of prominent oscillations of ventricular repolarization in the low-frequency range (0.04-0.15 Hz) to the incidence of ventricular arrhythmia and sudden death in post-MI patients and patients with ischaemic and non-ischaemic cardiomyopathy. It has been proposed that these oscillations reflect oscillations of ventricular action potential duration at the sympathetic nerve frequency. Here we review emerging evidence to support that contention and provide insight into possible underlying mechanisms for this association.

Keywords: Action potential duration; Arrhythmia; Beta-adrenergic stimulation; Electrophysiology; Low-frequency oscillations; Mechano-electric feedback; Repolarization; T wave.

Publication types

Review

MeSH terms

Action Potentials
Arrhythmias, Cardiac* / diagnosis
Electrocardiography
Heart Ventricles
Humans
Myocardial Infarction*