Published online Aug 16, 2015. doi: 10.12998/wjcc.v3.i8.705
Peer-review started: July 27, 2014
First decision: August 14, 2014
Revised: February 22, 2015
Accepted: June 4, 2015
Article in press: June 8, 2015
Published online: August 16, 2015
Malignant cardiac arrhythmias which result in sudden cardiac death may be present in individuals apparently healthy or be associated with other medical conditions. The way to predict their appearance represents a challenge for the medical community due to the tragic outcomes in most cases. In the last two decades some ventricular repolarization (VR) markers have been found to be useful to predict malignant cardiac arrhythmias in several clinical conditions. The corrected QT, QT dispersion, Tpeak-Tend, Tpeak-Tend dispersion and Tp-e/QT have been studied and implemented in clinical practice for this purpose. These markers are obtained from 12 lead surface electrocardiogram. In this review we discuss how these markers have demonstrated to be effective to predict malignant arrhythmias in medical conditions such as long and short QT syndromes, Brugada syndrome, early repolarization syndrome, acute myocardial ischemia, heart failure, hypertension, diabetes mellitus, obesity and highly trained athletes. Also the main pathophysiological mechanisms that explain the arrhythmogenic predisposition in these diseases and the basis for the VR markers are discussed. However, the same results have not been found in all conditions. Further studies are needed to reach a global consensus in order to incorporate these VR parameters in risk stratification of these patients.
Core tip: Malignant ventricular arrhythmias are a common cause of sudden cardiac death in clinical practice. They may present in individuals apparently healthy or be associated with other medical conditions. It is possible to predict the appearances of ventricular arrhythmias by analysing ventricular repolarization markers through surface 12 leads electrocardiogram. It may represent a tool to evaluate the risk stratification and for achieving a better medical management of our patients.