Electrocardiographic T-wave abnormalities and premature ventricular contraction burden in patients with palpitations: a regional study from Northeast India
Bharadwaj, Rajeev Kalita, Suman Sahu, Rudrakshya Ahmad, Saif Banskota, Durlav Mungase, Suraj
Bharadwaj, Rajeev
Kalita, Suman
Sahu, Rudrakshya
Ahmad, Saif
Banskota, Durlav
Mungase, Suraj
Affiliation
All India Institute of Medical Sciences; University Hospitals Birmingham NHS Foundation Trust; University Hospitals of North Midlands NHS Trust; Indian National Institute of Pharmaceutical Education and Research
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Publication date
2025-06-09
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Abstract
Background: Premature ventricular contractions (PVCs), often presenting as palpitations, are common in cardiology outpatient settings. While a high PVC burden is linked to adverse cardiac outcomes, its detection typically requires 24-hour Holter monitoring - an investigation not always feasible in resource-limited settings. Electrocardiographic (ECG) markers of ventricular repolarization, represented by T-wave abnormalities, such as Tp-Te interval, Tp-Te/QT ratio, and QTc dispersion, may serve as accessible surrogate indicators of PVC burden.
Objective: To evaluate the correlation between surface ECG-derived repolarization markers and PVC burden and determine which parameters best predict higher PVC burden in patients presenting with palpitations.
Methodology: A total of 87 adult patients with palpitations referred to a tertiary care cardiology clinic in Northeast India underwent 12-lead ECG and 24-hour Holter monitoring. Patients were stratified into two groups based on PVC burden (<1% vs. >1%). ECG parameters, including T-wave axis angle, frontal QRS-T (fQRS-T) angle, Tp-Te interval, Tp-Te dispersion, Tp-Te/QT ratio, and QTc dispersion, were compared. Statistical analysis included Welch's t-test and Spearman's correlation.
Results: Tp-Te interval (r = 0.5), Tp-Te/QT ratio (r = 0.4), and QTc dispersion (r = 0.3) demonstrated significant positive correlations with total PVC burden. These parameters were also significantly higher in the >1% PVC burden group (P < 0.05). No significant correlation was observed with T-wave axis or fQRS-T angle.
Conclusions: Among surface ECG markers studied, Tp-Te interval, Tp-Te/QT ratio, and QTc dispersion showed the strongest correlation with PVC burden in patients presenting with palpitations. These accessible and non-invasive markers may help identify patients at risk of higher PVC loads who may benefit from further evaluation, especially in settings where Holter monitoring is limited.
Citation
Bharadwaj R, Kalita S, Sahu R, Ahmad S, Banskota D, Mungase S. Electrocardiographic T-wave Abnormalities and Premature Ventricular Contraction Burden in Patients With Palpitations: A Regional Study From Northeast India. Cureus. 2025 Jun 9;17(6):e85629. doi: 10.7759/cureus.85629.
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Article