Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Critical Care Medicine

Background: Tpeak-end prolongation(the interval from the peak of T wave and the end of it) and Tpeak-end/QT ratio have been shown to be prdictors of malignant ventricular arrythmias in various cardiac conditions. Objectives: The purpose of this study was to show the significance of using T peak-end and T peak-end/QT ratio at admission in patients with acute ST-segment elevation MI to predict malignant ventricular arrythmia. Methods: This is a controlled prospective observation cohort study. The study group included 60 patients presented with STEMI, in whom Tpeak-end and Tpeak-end/QT ratio were measured at admission to our hospital, these patients were monitored for malignant arrythmia (VT and VF) with continous monitoring (ECG) in our intensive care unit for 5 days and 20 healthy individuals acted as controls. Results: The Tpeak-end (94.3± 21.2 msec and Tpeak-end/QT ratio (26±6%) in patients with STEMI. Ten patients with STEMI who sustained ventricular tachycardia within 24 hours of admission had prolonged Tpeak-end compared to 50 patient with STEMI without sustained VT(116.0±22.7msec versus 90.0±18.2 msec, P value <0.001) and Tpeak-end/QT ratio (0.32±0.05 versus 0.25±0,05, P value <0.001). Four patients with STEMI who sustained ventriculal fibrilation within 24 hours of admission had prolonged Tpeak-end compared to 56 patient with STEMI without sustained VF (120.0 ±28.28 msec versus 92.5±19.65 msec, P value 0.011) and Tpeak-end/QT ratio (0.33±0.08 versus 0.26±0.05, P value 0.011). ROC showed Tpeak of 110 msec to predict occurrence of VT had AUC 81.5%, sensitivity 80.0% and specificity 90.0% and to predict VF had AUC 80.1%, sensitivity 50.0% and specificity 70%

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