Evaluation of Ventricular Repolarization Variability in Patients With Nonischemic Dilated Cardiomyopathy From Vectorcardiography

To investigate the predictive value of Ventricular repolarization variability (VRV) in patients with nonischemic dilated cardiomyopathy, we analyzed the Defibrillator in Non-Ischemic Cardiomyopathy Treatment Evaluation trial (DEFINITE). The Telemetric and Holter ECG Warehouse (THEW) data set E-HOL-03-0401-017 comprises 393 recordings from 236 patients. All patients had a left ventricular ejection fraction < 36 % and were randomized to receiving standard medical therapy with or without an ICD. 24h-Holter 3-lead (Frank lead system) ECGs were performed at enrollment and after up to 5 years' follow-up. The all-cause mortality during the follow-up period was 4.8 %. We analyzed three-dimensional variability of the Tloop and QT interval variability on a single lead basis by employing three-dimensional signals adaptation and twodimensional signal warping, respectively, to quantify VRV. To assess the predictive value of VRV parameters, KaplanMeier survival curves of baseline Holter ECGs were calculated. Our results showed significant association to survival (P < 0.01 by the log-rank test) for T wave amplitude corrected QT interval variability index (cQTVi) on single lead basis. Low cQTVi group showed no mortality for the entire observation period. We found no associations between cQTVi groups and patient-specific parameters.