Trial reportCirculation. Arrhythmia and electrophysiology2012
Crescendo in depolarization and repolarization heterogeneity heralds development of ventricular tachycardia in hospitalized patients with decompensated heart failure.
Trial report in Circulation. Arrhythmia and electrophysiology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00270400 (Natrecor), which is not on this map. Cited by 19 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Natrecor (Nesiritide) Versus Dobutamine Therapy for Symptomatic, Decompensated CHF: A Safety Study Using 24-Hour Holter Monitoring - The PRECEDENT Trial: Prospective, Randomized Evaluation of Cardiac Ectopy With Dobutamine or Natrecor Therapy
Who cites it
19 citing papers in PubMed, 44 citations in OpenAlex.
- Marked exercise-induced T-wave heterogeneity in symptomatic diabetic patients with nonflow-limiting coronary artery stenosis.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2018Trial
- AI-Based QRS Onset Detection in the Early Ventricular Activation Site ECGs.IEEE journal of biomedical and health informatics · 2026Article
- Ventricular Depolarization Abnormalities and Their Role in Cardiac Risk Stratification - A Narrative Review.Reviews in cardiovascular medicine · 2025Review
- Reduced connexin-43 expression, slow conduction and repolarisation dispersion in a model of hypertrophic cardiomyopathy.Disease models & mechanisms · 2024Article
- T-Wave Analysis on the 24 h Holter ECG Monitoring as a Predictive Assessment of Major Adverse Cardiovascular Events in Patients with Myocardial Infarction: A Literature Review and Future Perspectives.Life (Basel, Switzerland) · 2023Review
- Spatial variance in the 12-lead ECG and mechanical dyssynchrony.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2021Article
- Spectrum of clinical applications of interlead ECG heterogeneity assessment: From myocardial ischemia detection to sudden cardiac death risk stratification.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2021Review
- Microvolt T-Wave Alternans Is Modulated by Acute Low-Level Tragus Stimulation in Patients With Ischemic Cardiomyopathy and Heart Failure.Frontiers in physiology · 2021Article
- Real-Time Closed-Loop Suppression of Repolarization Alternans Reduces Arrhythmia Susceptibility In Vivo.Circulation. Arrhythmia and electrophysiology · 2020Article
- Cardiac Alternans: Mechanisms and Clinical Utility in Arrhythmia Prevention.Journal of the American Heart Association · 2019Review
- Utility of a Smartphone Based System (cvrPhone) to Predict Short-term Arrhythmia Susceptibility.Scientific reports · 2019Article
- Risk Stratification of Sudden Cardiac Death After Acute Myocardial Infarction.The Journal of innovations in cardiac rhythm management · 2018Review
- Analysis of speed, curvature, planarity and frequency characteristics of heart vector movement to evaluate the electrophysiological substrate associated with ventricular tachycardia.Computers in biology and medicine · 2015Article
- Multilead template-derived residua of surface ECGS for quantitative assessment of arrhythmia risk.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2015Article
- Evolution of action potential alternans in rabbit heart during acute regional ischemia.BioMed research international · 2015Article
- A translational approach to probe the proarrhythmic potential of cardiac alternans: a reversible overture to arrhythmogenesis?American journal of physiology. Heart and circulatory physiology · 2014Review
- T-wave alternans as an arrhythmic risk stratifier: state of the art.Current cardiology reports · 2013Review
- Article
- Spatial heterogeneity of electrical restitution as a predictor of ventricular tachyarrhythmias: a lumped-parameter approach.Journal of the American Heart Association · 2012Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundA critical need exists for reliable warning markers of in-hospital life-threatening arrhythmias. We used a new quantitative method to track interlead heterogeneity of depolarization and repolarization to detect premonitory changes before ventricular tachycardia (VT) in hospitalized patients with acute decompensated heart failure. METHODS AND
resultsAmbulatory ECGs (leads V(1), V(5), and aVF) recorded before initiation of drug therapy from patients enrolled in the PRECEDENT (Prospective Randomized Evaluation of Cardiac Ectopy with Dobutamine or Nesiritide Therapy) trial were analyzed. R-wave heterogeneity (RWH) and T-wave heterogeneity (TWH) were assessed by second central moment analysis and T-wave alternans (TWA) by modified moving average analysis. Of 44 patients studied, 22 had experienced episodes of VT (≥4 beats at heart rates >100 beats/min) following ≥120 minutes of stable sinus rhythm, and 22 were age- and sex-matched patients without VT. TWA increased from 18.6±2.1 μV (baseline, mean±SEM) to 27.9±4.6 μV in lead V(5) at 15 to 30 minutes before VT (P<0.05) and remained elevated until the arrhythmia occurred. TWA results in leads V(1) and aVF were similar. RWH and TWH were elevated from 164.1±33.1 and 134.5±20.6 μV (baseline) to 299.8±54.5 and 239.2±37.0 μV at 30 to 45 minutes before VT (P<0.05), respectively, preceding the crescendo in TWA by 15 minutes. Matched patients without VT did not display elevated RWH (185.5±29.4 μV) or TWH (157.1±27.2 μV) during the 24-hour period.
conclusionsThis investigation is the first clinical demonstration of the potential utility of tracking depolarization and repolarization heterogeneity to detect crescendos in electrical instability that could forewarn of impending nonsustained VT. Clinical Trial Registration- URL: http://www.clinicaltrials.gov. Unique identifier: NCT00270400.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.