B Vandenberk1, T Robyns2, G Goovaerts3, S Van Soest4, V Floré5, C Garweg2, S Van Huffel3, J Ector2, R Willems2. 1. Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; Department of Cardiology, University Hospitals Leuven, Leuven, Belgium. Electronic address: bert.vandenberk@kuleuven.be. 2. Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; Department of Cardiology, University Hospitals Leuven, Leuven, Belgium. 3. Department of Electrical Engineering (ESAT), STADIUS Center for Dynamical Systems, Signal Processing and Data Analytics, KU Leuven, Leuven, Belgium.; IMinds Medical IT, Leuven, Belgium. 4. Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium. 5. Department of Cardiology, University Hospitals Leuven, Leuven, Belgium.
Abstract
AIMS: QRS fragmentation (fQRS) has been proposed as a predictor of sudden cardiac death (SCD) and all-cause mortality in ischemic (ICM) and non-ischemic cardiomyopathy patients. However the value of fQRS in patients with a LVEF <35% is a matter of debate. METHODS: All consecutive patients with an indication for an ICD in primary prevention of SCD were included in a retrospective registry from 1996 until 2013. Twelve lead electrocardiograms before implant were analyzed for the presence of fQRS in different regions. Adjusted Cox regression analysis for first appropriate ICD shock (AS) and all-cause mortality was performed. RESULTS: In total 407 patients were included with a mean follow-up of 4.2±3.3y (age 60.6±11.9y, 15.7% female and 52.8% ICM). fQRS was present in 46.7% of patients, predominantly inferior (30.7%) followed by anterior (21.4%) and lateral (11.1%) coronary artery territories. fQRS was significantly more prevalent in ICM (p=0.004). Inferior fQRS was an independent predictor of a first AS within 1y (HR 2.55, 95%CI 1.28-5.07) and 3y (HR 1.90, 95%CI 1.14-3.18) after implantation. Whereas, anterior fQRS was an independent predictor of all-cause mortality within 1y (HR 4.58, 95%CI 1.29-16.19), 3y (HR 3.92, 95%CI 1.77-8.65) and the complete follow-up (HR 2.22, 95%CI 1.33-3.69). Lateral fQRS was only a predictor of late (>3y of follow-up) all-cause mortality (HR 2.04, 95%CI 1.09-3.81). CONCLUSIONS: fQRS in a specific coronary artery territory might be promising to discriminate arrhythmic from mortality risk. Inferior fQRS was a predictor of early arrhythmia, while anterior fQRS was related to mortality.
AIMS: QRS fragmentation (fQRS) has been proposed as a predictor of sudden cardiac death (SCD) and all-cause mortality in ischemic (ICM) and non-ischemiccardiomyopathypatients. However the value of fQRS in patients with a LVEF <35% is a matter of debate. METHODS: All consecutive patients with an indication for an ICD in primary prevention of SCD were included in a retrospective registry from 1996 until 2013. Twelve lead electrocardiograms before implant were analyzed for the presence of fQRS in different regions. Adjusted Cox regression analysis for first appropriate ICD shock (AS) and all-cause mortality was performed. RESULTS: In total 407 patients were included with a mean follow-up of 4.2±3.3y (age 60.6±11.9y, 15.7% female and 52.8% ICM). fQRS was present in 46.7% of patients, predominantly inferior (30.7%) followed by anterior (21.4%) and lateral (11.1%) coronary artery territories. fQRS was significantly more prevalent in ICM (p=0.004). Inferior fQRS was an independent predictor of a first AS within 1y (HR 2.55, 95%CI 1.28-5.07) and 3y (HR 1.90, 95%CI 1.14-3.18) after implantation. Whereas, anterior fQRS was an independent predictor of all-cause mortality within 1y (HR 4.58, 95%CI 1.29-16.19), 3y (HR 3.92, 95%CI 1.77-8.65) and the complete follow-up (HR 2.22, 95%CI 1.33-3.69). Lateral fQRS was only a predictor of late (>3y of follow-up) all-cause mortality (HR 2.04, 95%CI 1.09-3.81). CONCLUSIONS: fQRS in a specific coronary artery territory might be promising to discriminate arrhythmic from mortality risk. Inferior fQRS was a predictor of early arrhythmia, while anterior fQRS was related to mortality.
Authors: Bert Vandenberk; M Juhani Junttila; Tomas Robyns; Christophe Garweg; Joris Ector; Heikki V Huikuri; Rik Willems Journal: Ann Noninvasive Electrocardiol Date: 2018-09-28 Impact factor: 1.468
Authors: Amalia Villa; Bert Vandenberk; Tuomas Kenttä; Sebastian Ingelaere; Heikki V Huikuri; Markus Zabel; Tim Friede; Christian Sticherling; Anton Tuinenburg; Marek Malik; Sabine Van Huffel; Rik Willems; Carolina Varon Journal: Sci Rep Date: 2022-04-26 Impact factor: 4.996
Authors: Markus Zabel; Christian Sticherling; Rik Willems; Andrzej Lubinski; Axel Bauer; Leonard Bergau; Frieder Braunschweig; Josep Brugada; Sandro Brusich; David Conen; Iwona Cygankiewicz; Panagiota Flevari; Milos Taborsky; Jim Hansen; Gerd Hasenfuß; Robert Hatala; Heikki V Huikuri; Svetoslav Iovev; Stefan Kääb; Gabriela Kaliska; Jaroslaw D Kasprzak; Lars Lüthje; Marek Malik; Tomas Novotny; Nikola Pavlović; Georg Schmidt; Tchavdar Shalganov; Rajeeva Sritharan; Simon Schlögl; Janko Szavits Nossan; Vassil Traykov; Anton E Tuinenburg; Vasil Velchev; Marc A Vos; Stefan N Willich; Tim Friede; Jesper Hastrup Svendsen; Béla Merkely Journal: ESC Heart Fail Date: 2018-10-09