Abstract
Introduction: T-wave morphology and P-wave morphology have been observed to have prognostic significance. However, data about their relation with arrhythmic substrate represented by left ventricular fibrosis are limited. Methods: We evaluated associations of T- and P-wave morphology parameters analyzed from the standard 12-lead ECGs with left ventricular fibrosis in 379 victims of unexpected sudden cardiac death who underwent medico-legal autopsy. Results: T-wave and P-wave area dispersion (TWAd, PWAd) (low values abnormal), non-dipolar components of T-wave and P-wave morphology (T_NonDipolarABS, P_NonDipolarABS) (high values abnormal) all had a significant association with left ventricular fibrosis (p=0.008, p=0.011, p=0.027, p=0.005 between the groups with different stages of left ventricular fibrosis, respectively, post hoc Bonferroni p-values are shown in Figures). Conclusions: Abnormal values of T- and P-wave morphology are associated with arrhythmic substrate represented by ventricular fibrosis partly explaining the mechanism behind their prognostic significance.
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