IngentaConnect Electrocardiographic T- and U-Wave Discordance

Authors: Michael G. Reinig¹; Robert Harizi¹; David H. Spodick¹

Source: Annals of Noninvasive Electrocardiology, Volume 10, Number 1, January 2005 , pp. 41-46(6)

Abstract:

Background: Abundant information has been reported regarding the U wave, which almost entirely has been focused on U waves in isolation. There has been little investigation of discordant T and U waves.

Methods: Of 18,750 consecutively recorded electrocardiograms, 143 patients were categorized resulting in three groups. Group A: 53 patients with negative T waves and positive U waves (Type I Discordance); Group B: 26 patients with positive T waves and negative U waves (Type II Discordance); and Group C: 63 patients with negative T and negative U waves. Each patient's chart was reviewed for relevant clinical, laboratory, and medical history.

Results: Coronary disease was slightly more common in Group A (64%) than in Group B (46%) (P = 0.174; ns). Coronary disease in Group C was extremely common (88%; P <0.001). Hypertension in the two discordant groups was similar: Group A (60%) versus Group B (58%) (P = ns), Group C was significantly higher (88%) (P <0.001). Left ventricular hypertrophy was 49% in Group A and 58% in Group B (P = ns), but Group C was significantly higher at 70% (P = 0.038).

Conclusions: This appears to be the first investigation of the associations of discordant T and U waves. We found that the significance of any U wave is not independent of their respective T wave. In addition, we propose that the U wave not be analyzed in isolation, but rather with respect to its T wave.

A.N.E. 2005;10(1):41–46

Keywords: electrocardiography; U waves; T-U wave relations

Document Type: Research article

DOI: 10.1111/j.1542-474X.2005.00596.x

Affiliations: 1: Cardiology Division, Saint Vincent Hospital, Worcester Medical Center, University of Massachusetts Medical School, Worcester, Massachusetts

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