Post extrasystolic T wave change in subjectswith structural healthy ventricles - Measurement and simulation

The risk stratification of sudden cardiac death after myocardial infarction plays an important role in cardiology. It influences the treatment of a patient and the use of implantable devices. However, the majority of well known methods for stratifying risk still fail to predict sudden cardiac death with high accuracy. The heart rate turbulence delivers good results that could be complemented by studying ECG morphology. For this purpose, the post extrasystolic T wave change was studied in this work. 10 patients with structural healthy ventricles were paced in the right ventricular apex and the subsequent response of the heart was measured in the ECG. Complementary, computer simulations of the human transmembrane voltages and posterior ECG reconstruction were also carried out. Morphological changes in the post extrasystolic T wave and its restitution to the original shape were measurable in every patient of this study. The patients presented diminished or alternating postectopic T waves and prolongation of T wave duration. However, the simulation does not present significant T wave changes. Furthermore, the new morphological parameters do not seem to correlate with the standard HRT parameters.