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- Title:
QRS complex and T wave planarity for the efficacy prediction of automatic implantable defibrillators.
- Document type:
- Journal Article
- Author(s):
- Hnatkova, Katerina; Andršová, Irena; Novotný, Tomáš; Vanderberk, Bert; Sprenkeler, David; Junttila, Juhani; Reichlin, Tobias; Schlögl, Simon; Vos, Marc A; Friede, Tim; Bauer, Axel; Huikuri, Heikki V; Willems, Rik; Schmidt, Georg; Sticherling, Christian; Zabel, Markus; Malik, Marek
- Abstract:
- 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.
- Journal title abbreviation:
- Heart
- Year:
- 2024
- Journal volume:
- 110
- Journal issue:
- 3
- Pages contribution:
- 178-187
- Fulltext / DOI:
- doi:10.1136/heartjnl-2023-322878
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/37714697
- Print-ISSN:
- 1355-6037
- TUM Institution:
- Klinik und Poliklinik für Innere Medizin I, Kardiologie (Prof. Laugwitz)
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