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BACKGROUND: Increased spatial dispersion of restitution properties has been associated to arrhythmic risk. An ECG-based index quantifying restitution dispersion, DRest, is evaluated in patients who experienced Torsades de Pointes (TdP) under sotalol challenge and compared with the response in healthy subjects. METHODS AND RESULTS: ECG recordings were analyzed for quantification of DRest and QTc, among others biomarkers. DRest provides improved discrimination following sotalol administration between TdP and healthy subjects ([min-max]: [0.18-0.22] vs [0.02-0.12]), compared to other biomarkers including QTc ([436-548ms] vs [376-467ms]). Results in healthy subjects are in agreement with simulations of sotalol effects on a human tissue electrophysiological model. CONCLUSIONS: This case study supports the potential of DRest for improved arrhythmia risk stratification even with QTc values below 450ms.

Original publication




Journal article


J Electrocardiol

Publication Date





867 - 873


APD restitution, Rate adaptation, cardiotoxicity, sotalol, Anti-Arrhythmia Agents, Diagnosis, Computer-Assisted, Electrocardiography, Humans, Reproducibility of Results, Risk Assessment, Sensitivity and Specificity, Sotalol, Torsades de Pointes, Treatment Outcome