Towards a new generation of dynamic indices for the assessment of drug-induced proarrhythmic risk

FRANCISCO JAVIER ALVARADO RODRÍGUEZ; ROMO-VÁZQUEZ; CRUCES, PABLO DANIEL; ARINI, PEDRO DAVID

San Juan

Congreso; XIX REUNIÓN DE TRABAJO EN PROCESAMIENTO DE LA INFORMACIÓN Y CONTROL; 2021

Instituto de Automática de la Universidad Nacional de San Juan (UNSJ)

The detection of proarrhythmic side effectsin many marketed drugs has prompted the search forcomplementary non-invasive markers of cardiotoxicityrisk. Novel indices based on the study of cardiac vectordynamics have now emerged. Herein, we use quaternionmethods to study alterations in the angular velocityduring ventricular repolarization. The assessment wasconducted in patients with Torsade de Pointes episodeswhen undergoing a Sotalol treatment. The algorithmincludes a Principal Component Analysis to homogenizethe information from three databases and, at the sametime, reduce the space to three dimensions. Significantdifferences were found (p < 5E-4) in the angular velocityof the second half of repolarization loop (T-wave). Theratio between the maximums of the angular velocity inboth T-wave halves showed a trend to 1 in the proximityof an arrhythmic event and reached sensitivity/specificitypair of 97/100 (AUC 0.99) in the comparison of healthypopulation with at-risk patients. The high performanceof the method exceeded the expectations of the standardmeasurement and it becomes a promising outcome forthe development of safe drug therapies.