QRS complex and T wave planarity for the efficacy prediction of automatic implantable defibrillators
Jazyk angličtina Země Anglie, Velká Británie Médium electronic
Typ dokumentu časopisecké články
Grantová podpora
NH/16/2/32499
British Heart Foundation - United Kingdom
PubMed
37714697
PubMed Central
PMC10850677
DOI
10.1136/heartjnl-2023-322878
PII: heartjnl-2023-322878
Knihovny.cz E-zdroje
- Klíčová slova
- Biomarkers, Defibrillators, Implantable, Electrocardiography,
- MeSH
- defibrilátory implantabilní * škodlivé účinky MeSH
- elektrokardiografie metody MeSH
- funkce levé komory srdeční MeSH
- ischemická choroba srdeční * komplikace MeSH
- lidé MeSH
- náhlá srdeční smrt etiologie prevence a kontrola MeSH
- nemoci koronárních tepen * komplikace MeSH
- rizikové faktory MeSH
- senioři MeSH
- srdeční arytmie diagnóza terapie etiologie MeSH
- tepový objem MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: To test the hypothesis that in recipients of primary prophylactic implantable cardioverter-defibrillators (ICDs), the non-planarity of ECG vector loops predicts (a) deaths despite ICD protection and (b) appropriate ICD shocks. METHODS: Digital pre-implant ECGs were collected in 1948 ICD recipients: 21.4% females, median age 65 years, 61.5% ischaemic heart disease (IHD). QRS and T wave three-dimensional loops were constructed using singular value decomposition that allowed to measure the vector loop planarity. The non-planarity, that is, the twist of the three-dimensional loops out of a single plane, was related to all-cause mortality (n=294; 15.3% females; 68.7% IHD) and appropriate ICD shocks (n=162; 10.5% females; 87.7% IHD) during 5-year follow-up after device implantation. Using multivariable Cox regression, the predictive power of QRS and T wave non-planarity was compared with that of age, heart rate, left ventricular ejection fraction, QRS duration, spatial QRS-T angle, QTc interval and T-peak to T-end interval. RESULTS: QRS non-planarity was significantly (p<0.001) associated with follow-up deaths despite ICD protection with HR of 1.339 (95% CI 1.165 to 1.540) but was only univariably associated with appropriate ICD shocks. Non-planarity of the T wave loop was the only ECG-derived index significantly (p<0.001) associated with appropriate ICD shocks with multivariable Cox regression HR of 1.364 (1.180 to 1.576) but was not associated with follow-up mortality. CONCLUSIONS: The analysed data suggest that QRS and T wave non-planarity might offer distinction between patients who are at greater risk of death despite ICD protection and those who are likely to use the defibrillator protection.
Cardiology and Pneumology Heart Center University Hospital Göttingen Göttingen Germany
Department of Cardiology and Pneumology University Medical Center Göttingen Gottingen Germany
Department of Cardiology Inselspital Bern University Hospital Bern Switzerland
Department of Cardiology University Hospital of Basel Basel Switzerland
Department of Cardiovascular Sciences University of Leuven Leuven Belgium
Department of Internal Medicine and Cardiology Masaryk University Brno Czech Republic
Department of Internal Medicine and Cardiology University Hospital Brno Brno Czech Republic
Department of Medical Physiology University Medical Center Utrecht Utrecht The Netherlands
Department of Medical Statistics University Medical Center Göttingen Göttingen Germany
Division of Clinical Cardiology University Hospitals Leuven Leuven Belgium
German Center of Cardiovascular Research partner site Göttingen Göttingen Germany
Medizinische Klinik Klinikum rechts der Isar der Technischen Universität München Munich Germany
MRC Oulu University Central Hospital of Oulu and University of Oulu Oulu Finland
National Heart and Lung Institute Imperial College London London UK
University Central Hospital of Oulu and University of Oulu Oulu Finland
University Hospital for Internal Medicine 3 Medical University Innsbruck Innsbruck Austria
doi: 10.1136/heartjnl-2023-323232 PubMed
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