Salah S Al-Zaiti1, James A Fallavollita2, John M Canty3, Mary G Carey4. 1. Department of Acute and Tertiary Care, School of Nursing, University of Pittsburgh, PA, USA. Electronic address: ssa33@pitt.edu. 2. VA WNY Health Care System at Buffalo, USA; Department of Medicine at The University at Buffalo, NY, USA; Center for Research in Cardiovascular Medicine at The University at Buffalo, NY, USA. 3. VA WNY Health Care System at Buffalo, USA; Department of Medicine at The University at Buffalo, NY, USA; Department of Physiology & Biophysics at The University at Buffalo, NY, USA; Department of Biomedical Engineering at The University at Buffalo, NY, USA; Center for Research in Cardiovascular Medicine at The University at Buffalo, NY, USA. 4. Strong Memorial Hospital at University of Rochester Medical Center, Rochester, NY, USA.
Abstract
OBJECTIVE: This study evaluated the prognostic value of electrocardiogram (ECG)-based predictors in the primary prevention of sudden cardiac arrest (SCA) among ischemic cardiomyopathy patients with depressed left ventricular ejection fraction (LVEF ≤35%). BACKGROUND: The prediction of cause-specific mortality in high-risk patients offers the potential for targeting specific therapies (i.e., implantable cardioverter-defibrillator [ICD]). METHODS: Subjects were recruited from the Prediction of Arrhythmic Events with Positron Emission Tomography (PAREPET) study. Continuous Holter 12-lead ECG recordings were obtained at the start of study and used to compute 15 clinically-important ECG abnormalities (e.g., atrial fibrillation). RESULTS: Among 197 patients (age 67 ± 11 years, 93% male, mean follow-up 4.1 years) enrolled, 30 (15%) were SCA cases and 35 (18%) cardiac non-sudden deaths (C/NS). In multivariate analysis, only heart-rate-corrected QT interval (QTc) predicted SCA (hazard ratio 2.9 [1.2-7.3]) and only depressed heart rate variability (HRV) predicted C/NS (hazard ratio 5.0 [1.5-17.1]) independent of demographic and clinical parameters. CONCLUSIONS: Among patients with depressed LVEF, prolonged QTc suggests greater potential benefit from ICD therapy to prevent SCA; depressed HRV suggests potential benefit from bi-ventricular pacing to prevent C/NS.
OBJECTIVE: This study evaluated the prognostic value of electrocardiogram (ECG)-based predictors in the primary prevention of sudden cardiac arrest (SCA) among ischemic cardiomyopathypatients with depressed left ventricular ejection fraction (LVEF ≤35%). BACKGROUND: The prediction of cause-specific mortality in high-risk patients offers the potential for targeting specific therapies (i.e., implantable cardioverter-defibrillator [ICD]). METHODS: Subjects were recruited from the Prediction of Arrhythmic Events with Positron Emission Tomography (PAREPET) study. Continuous Holter 12-lead ECG recordings were obtained at the start of study and used to compute 15 clinically-important ECG abnormalities (e.g., atrial fibrillation). RESULTS: Among 197 patients (age 67 ± 11 years, 93% male, mean follow-up 4.1 years) enrolled, 30 (15%) were SCA cases and 35 (18%) cardiac non-sudden deaths (C/NS). In multivariate analysis, only heart-rate-corrected QT interval (QTc) predicted SCA (hazard ratio 2.9 [1.2-7.3]) and only depressed heart rate variability (HRV) predicted C/NS (hazard ratio 5.0 [1.5-17.1]) independent of demographic and clinical parameters. CONCLUSIONS: Among patients with depressed LVEF, prolonged QTc suggests greater potential benefit from ICD therapy to prevent SCA; depressed HRV suggests potential benefit from bi-ventricular pacing to prevent C/NS.
Authors: S G Priori; E Aliot; C Blomstrom-Lundqvist; L Bossaert; G Breithardt; P Brugada; A J Camm; R Cappato; S M Cobbe; C Di Mario; B J Maron; W J McKenna; A K Pedersen; U Ravens; P J Schwartz; M Trusz-Gluza; P Vardas; H J Wellens; D P Zipes Journal: Eur Heart J Date: 2001-08 Impact factor: 29.983
Authors: Sabine M J M Straus; Jan A Kors; Marie L De Bruin; Cornelis S van der Hooft; Albert Hofman; Jan Heeringa; Jaap W Deckers; J Herre Kingma; Miriam C J M Sturkenboom; Bruno H Ch Stricker; Jacqueline C M Witteman Journal: J Am Coll Cardiol Date: 2006-01-17 Impact factor: 24.094
Authors: P Klootwijk; A Langer; S Meij; C Green; R F Veldkamp; A M Ross; P W Armstrong; M L Simoons Journal: Eur Heart J Date: 1996-05 Impact factor: 29.983
Authors: Juha S Perkiömäki; Miia Hyytinen-Oinas; Mari Karsikas; Tapio Seppänen; Katerina Hnatkova; Marek Malik; Heikki V Huikuri Journal: Am J Cardiol Date: 2006-02-01 Impact factor: 2.778
Authors: Julia H Indik; Vineet Nair; Ruslan Rafikov; Iwan S Nyotowidjojo; Jaskanwal Bisla; Mayank Kansal; Devang S Parikh; Melissa Robinson; Anand Desai; Megha Oberoi; Akash Gupta; Taimur Abbasi; Zain Khalpey; Amit R Patel; Roberto M Lang; Samuel C Dudley; Bum-Rak Choi; Joe G N Garcia; Roberto F Machado; Ankit A Desai Journal: PLoS One Date: 2016-10-13 Impact factor: 3.240