University of Oulu

Rahola, JT, Kiviniemi, AM, Ukkola, OH, et al. Temporal variability of T-wave morphology and risk of sudden cardiac death in patients with coronary artery disease. Ann Noninvasive Electrocardiol. 2021; 26:e12830.

Temporal variability of T-wave morphology and risk of sudden cardiac death in patients with coronary artery disease

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Author: Rahola, Janne T.1; Kiviniemi, Antti M.1; Ukkola, Olavi H.1;
Organizations: 1Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
2Department of Physiology, Research Unit of Biomedicine, Faculty of Medicine, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
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Language: English
Published: John Wiley & Sons, 2021
Publish Date: 2021-07-08


Background: The possible relationship between temporal variability of electrocardiographic spatial heterogeneity of repolarization and the risk of sudden cardiac death (SCD) in patients with coronary artery disease (CAD) is not completely understood.

Methods: The standard deviation of T-wave morphology dispersion (TMD-SD), of QRST angle (QRSTA-SD), and of T-wave area dispersion (TW-Ad-SD) were analyzed on beat-to-beat basis from 10 min period of the baseline electrocardiographic recording in ARTEMIS study patients with angiographically verified CAD.

Results: After on average of 8.6 ± 2.3 years of follow-up, a total of 66 of the 1,678 present study subjects (3.9%) had experienced SCD or were resuscitated from sudden cardiac arrest (SCA). TMD-SD was most closely associated with the risk for SCD and was significantly higher in patients who had experienced SCD/SCA compared with those who remained alive (3.61 ± 2.83 vs. 2.64 ± 2.52, p = 0.008, respectively), but did not differ significantly between the patients who had experienced non-SCD (n = 71, 4.2%) and those who remained alive (3.20 ± 2.73 vs. 2.65 ± 2.53, p = 0.077, respectively) or between the patients who succumbed to non-cardiac death (n = 164, 9.8%) and those who stayed alive (2.64 ± 2.17 vs. 2.68 ± 2.58, p =0.853). After adjustments with relevant clinical risk indicators of SCD/SCA, TMD-SD still predicted SCD/SCA (HR 1.107, 95% CIs 1.035–1.185, p = 0.003).

Conclusions: Temporal variability of electrocardiographic spatial heterogeneity of repolarization represented by TMD-SD independently predicts long-term risk of SCD/SCA in patients with CAD.

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Series: Annals of noninvasive electrocardiology
ISSN: 1542-474X
ISSN-E: 1082-720X
ISSN-L: 1542-474X
Volume: 26
Issue: 3
Article number: e12830
DOI: 10.1111/anec.12830
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: The study is supported by a grant from the Sigrid Juselius Foundation, Helsinki, Finland, the Finnish Foundation for Cardiovascular Research, Helsinki, Finland, the Academy of Finland (#309447), Helsinki, Finland, and the Aarne Koskelo Foundation, Helsinki, Finland.
Academy of Finland Grant Number: 309447
Detailed Information: 309447 (Academy of Finland Funding decision)
Copyright information: © 2021 The Authors. Annals of Noninvasive Electrocardiology published by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.