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Dynamic repolarization assessment and arrhythmic risk stratification

Abstract:

A dynamic model is proposed to study the relationship between the QT and RR intervals of the surface electrocardiogram. The model accounts for the influence of a history of previous RR intervals on each QT, considering that such an influence may vary along the recording time. For identification of the model parameters, an adaptive methodology that uses the regularized Kalman filter is developed. A set of risk markers are derived from the estimated model parameters and they are tested on ambulatory recordings of postmyocardial infarction patients randomized to treatment with amiodarone or placebo. The results of our study show that amiodarone substantially modifies the QT interval response to heart rate changes. Furthermore, the way amiodarone acts on QT adaptation allows to identify patients in which treatment is being effective and separate them from those in which it is not and, consequently, are at higher risk of suffering from arrhythmic death.