Investigating the Role of Ventricular Repolarization Morphology in Surface ECGs for Identifying Patients with a History of Drug-Induced Arrhythmias

Assessing the propensity of an individual to drug-induced arrhythmias when exposed to a QT-prolonging drug is challenging because baseline QT prolongation has limited predictive value. In this study, we investigated the role of computerized ECG parameters quantifying T-wave morphology for the identification of individuals who developed drug-induced torsades de pointes (TdPs). In 34 patients, 5-minute digital ECGs have been acquired at baseline and during sotalol challenge. Seventeen of these patients had a history of drug-induced TdPs. We identified specific baseline features of the T-waves common to patients with history of TdPs. The sotalol-induced changes of T-wave morphologies were also different between the two groups suggesting that ECGs may provide relevant information for the identification of patients with an increased propensity to TdPs.