Reproducibility of Global Electrical Heterogeneity Measurements on 12-lead ECG: The Multi-Ethnic Study of Atherosclerosis

Overview

Journal J Electrocardiol

Specialty Cardiology & Vascular Diseases

Date 2021 Oct 9

PMID 34626835

Citations 8

Authors

Kazi T Haq

Katherine J Lutz

Kyle K Peters

Natalie E Craig

Evan Mitchell

Anish K Desai

Nathan W L Stencel

Elsayed Z Soliman

Joao A C Lima

Larisa G Tereshchenko

Affiliations

Soon will be listed here.

Abstract

Objective: Vectorcardiographic (VCG) global electrical heterogeneity (GEH) metrics showed clinical usefulness. We aimed to assess the reproducibility of GEH metrics.

Methods: GEH was measured on two 10-s 12‑lead ECGs recorded on the same day in 4316 participants of the Multi-Ethnic Study of Atherosclerosis (age 69.4 ± 9.4 y; 2317(54%) female, 1728 (40%) white, 1138(26%) African-American, 519(12%) Asian-American, 931(22%) Hispanic-American). GEH was measured on a median beat, comprised of the normal sinus (N), atrial fibrillation/flutter (S), and ventricular-paced (VP) beats. Spatial ventricular gradient's (SVG's) scalar was measured as sum absolute QRST integral (SAIQRST) and vector magnitude QT integral (VMQTi).

Results: Two N ECGs with heart rate (HR) bias of -0.64 (95% limits of agreement [LOA] -5.68 to 5.21) showed spatial area QRS-T angle (aQRST) bias of -0.12 (95%LOA -14.8 to 14.5). Two S ECGs with HR bias of 0.20 (95%LOA -15.8 to 16.2) showed aQRST bias of 1.37 (95%LOA -33.2 to 35.9). Two VP ECGs with HR bias of 0.25 (95%LOA -3.0 to 3.5) showed aQRST bias of -1.03 (95%LOA -11.9 to 9.9). After excluding premature atrial or ventricular beat and two additional beats (before and after extrasystole), the number of cardiac beats included in a median beat did not affect the GEH reproducibility. Mean-centered log-transformed values of SAIQRST and VMQTi demonstrated perfect agreement (Bias 0; 95%LOA -0.092 to 0.092).

Conclusion: GEH measurements on N, S, and VP median beats are reproducible. SVG's scalar can be measured as either SAIQRST or VMQTi.

Significance: Satisfactory reproducibility of GEH metrics supports their implementation.

Citing Articles

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