A Comparitive Study of QT Dispersion in Acute Myocardial Infarction between Early Reperfusion and Late Reperfusion Therapy
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 6
Abstract
Abstract: Coronary artery disease has become a global pandemic and one of the leading causes of morbidity and mortality among non-communicable diseases. One of the common complications seen in acute myocardial infarction is the development of arrhythmias, and is seen even before patient reaches the hospital. The complications leading to death in acute myocardial infarction such as malignant ventricular arrhythmias (like ventricular tachycardia and ventricular fibrillation) are very much preventable. QT dispersion (maximum QT interval minus minimum QT interval) was proposed as an index of the spatial dispersion of ventricular recovery. QTd measurement is an attempt by which we can distinguish homogenous myocardium from inhomogeneous myocardium. In other words increased QT dispersion reflects the disparity of ventricular recovery time. Hence QT dispersion provides a cheap, simple and non-invasive method to measure underlying dispersion of ventricular excitability. Q-T dispersion is defined as the difference between maximum and minimum Q-T interval in 12 lead electrocardiograms. QT dispersion represents dispersion of ventricular repolarization, and therefore, is a potential measure of substrates for re-entry tachycardia. QTd from surface ECG was developed as a simple non-invasive clinical risk marker to reflect dispersion of ventricular repolarization at the level of myocardium. Although its exact derivative is not yet fully understood or determined, QTd may depend on a composite of inhomogeneous repolarization forces which includes the T-wave vector and a changing component of local influences believed to be the main explanation for QTd. For many theoretical reasons, QTd may not represent the most useful ECG variable, actually reflecting the actual dispersion of ventricular repolarization. But it is very clear that dispersion of ventricular repolarization at the myocardial level is an important arrhythmogenic substrate. In our study we found that incidence of arrhythmias was high among late group, QT dispersion was higher among those who were perfused late and was lower in those with successful thrombolysis.
Authors and Affiliations
Dr. Karthik N, Dr. Nagaraj Nanjundaiah, Dr. Y. J. V. Reddy
Keywords
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