BACKGROUND: Identifying which patients might benefit the most from ICD therapy remains challenging. We hypothesize that increased T-wave alternans (TWA) and QT variability (QTV) provide complementary information for predicting appropriate ICD therapy in patients with previous myocardial infarction and reduced ejection fraction. METHODS: We analyzed 10-min resting ECGs from MADIT-II patients with baseline heart rate >80 beats/min. TWA indices IAA and IAA90 were computed with the multilead Laplacian Likelihood ratio method. QTV indices QTVN and QTVI were measured using a standard approach. Cox proportional hazard models were adjusted considering appropriate ICD therapy and sudden cardiac death (SCD) as endpoints. RESULTS:TWA and QTV were measured in 175 patients. Neither QTV nor TWA predicted SCD. Appropriate ICD therapy was predicted by combining IAA90 and QTVN after adjusting for relevant correlates. CONCLUSION:Increased TWA and QTV are independent predictors of appropriate ICD therapy in MADIT-II patients with elevated heart rate at baseline.
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BACKGROUND: Identifying which patients might benefit the most from ICD therapy remains challenging. We hypothesize that increased T-wave alternans (TWA) and QT variability (QTV) provide complementary information for predicting appropriate ICD therapy in patients with previous myocardial infarction and reduced ejection fraction. METHODS: We analyzed 10-min resting ECGs from MADIT-II patients with baseline heart rate >80 beats/min. TWA indices IAA and IAA90 were computed with the multilead Laplacian Likelihood ratio method. QTV indices QTVN and QTVI were measured using a standard approach. Cox proportional hazard models were adjusted considering appropriate ICD therapy and sudden cardiac death (SCD) as endpoints. RESULTS: TWA and QTV were measured in 175 patients. Neither QTV nor TWA predicted SCD. Appropriate ICD therapy was predicted by combining IAA90 and QTVN after adjusting for relevant correlates. CONCLUSION: Increased TWA and QTV are independent predictors of appropriate ICD therapy in MADIT-II patients with elevated heart rate at baseline.
Authors: Irena Andršová; Katerina Hnatkova; Martina Šišáková; Ondřej Toman; Peter Smetana; Katharina M Huster; Petra Barthel; Tomáš Novotný; Georg Schmidt; Marek Malik Journal: Diagnostics (Basel) Date: 2020-12-16
Authors: Ondřej Toman; Katerina Hnatkova; Martina Šišáková; Peter Smetana; Katharina M Huster; Petra Barthel; Tomáš Novotný; Irena Andršová; Georg Schmidt; Marek Malik Journal: Front Physiol Date: 2022-04-01 Impact factor: 4.755