Arrhythmias due to Inherited and Acquired Abnormalities of Ventricular Repolarization

Card Electrophysiol Clin. 2019 Jun;11(2):345-362. doi: 10.1016/j.ccep.2019.02.009. Epub 2019 Apr 10.

Abstract

Several acquired and congenital disease conditions and many cardiac and noncardiac drugs affect ventricular repolarization and increase susceptibility to ventricular arrhythmias. Abnormal ventricular repolarization can be reflected on the surface ECG by prolonged or shortened QT interval, early repolarization, and abnormal T-wave configuration. Reduced outward K+ currents and abnormal or increased sodium or calcium currents increase the vulnerability to ventricular arrhythmias. Multiple mechanisms give rise to ventricular arrhythmias in conditions of congenital or acquired abnormal ventricular repolarization. Ventricular arrhythmias associated with abnormalities of ventricular repolarization typically are rapid, usually polymorphic, ventricular tachycardia or torsades de pointes, often degenerating into ventricular fibrillation.

Keywords: Long QT syndrome; QT interval; Short QT Syndrome; Sudden death; T-wave alternans; Ventricular arrhythmias; Ventricular fibrillation; Ventricular repolarization.

Publication types

  • Review

MeSH terms

  • Arrhythmias, Cardiac* / classification
  • Arrhythmias, Cardiac* / diagnosis
  • Arrhythmias, Cardiac* / genetics
  • Arrhythmias, Cardiac* / physiopathology
  • Electrocardiography / classification*
  • Humans
  • Ventricular Fibrillation* / classification
  • Ventricular Fibrillation* / diagnosis
  • Ventricular Fibrillation* / genetics
  • Ventricular Fibrillation* / physiopathology