2014
Usefulness of Electrocardiographic Parameters for Risk Prediction in Arrhythmogenic Right Ventricular Dysplasia
SAGUNER, AM; S GANAHL; SH BALDINGER; Andrea KRAUS; A MEDEIROS-DOMINGO et. al.Basic information
Original name
Usefulness of Electrocardiographic Parameters for Risk Prediction in Arrhythmogenic Right Ventricular Dysplasia
Authors
SAGUNER, AM; S GANAHL; SH BALDINGER; Andrea KRAUS; A MEDEIROS-DOMINGO; S NORDBECK; AR SAGUNER; AS MUELLER-BURRI; LM HAEGELI; T WOLBER; J STEFFEL; N KRASNIQI; E DELACRETAZ; TF LUSCHER; L HELD; CB BRUNCKHORST and F DURU
Edition
American Journal of Cardiology, Bridgewater, Excerpta Medica Inc-Elsevier Science Inc, 2014, 0002-9149
Other information
Language
English
Type of outcome
Article in a journal
Confidentiality degree
is not subject to a state or trade secret
Impact factor
Impact factor: 3.276
UT WoS
000336339600023
Tags
International impact, Reviewed
Changed: 12/1/2016 23:31, Mgr. Andrea Kraus, M.Sc., Ph.D.
Abstract
V originále
The value of electrocardiographic findings predicting adverse outcome in patients with arrhythmogenic right ventricular dysplasia (ARVD) is not well known. We hypothesized that ventricular depolarization and repolarization abnormalities on the 12-lead surface electrocardiogram (ECG) predict adverse outcome in patients with ARVD. ECGs of 111 patients screened for the 2010 ARVD Task Force Criteria from 3 Swiss tertiary care centers were digitized and analyzed with a digital caliper by 2 independent observers blinded to the outcome. ECGs were compared in 2 patient groups: (1) patients with major adverse cardiovascular events (MACE: a composite of cardiac death, heart transplantation, survived sudden cardiac death, ventricular fibrillation, sustained ventricular tachycardia, or arrhythmic syncope) and (2) all remaining patients. A total of 51 patients (46%) experienced MACE during a follow-up period with median of 4.6 years (interquartile range 1.8 to 10.0). Kaplan-Meier analysis revealed reduced times to MACE for patients with repolarization abnormalities according to Task Force Criteria (p = 0.009), a precordial QRS amplitude ratio (Sigma QRS mV V-1 to V-3/Sigma QRS mV V-1 to V-6) of <= 0.48 (p = 0.019), and QRS fragmentation (p = 0.045). In multivariable Cox regression, a precordial QRS amplitude ratio of <= 0.48 (hazard ratio [HR] 2.92, 95% confidence interval [CI] 1.39 to 6.15, p = 0.005), inferior leads T-wave inversions (HR 2.44, 95% CI 1.15 to 5.18, p = 0.020), and QRS fragmentation (HR 2.65, 95% CI 1.1 to 6.34, p = 0.029) remained as independent predictors of MACE. In conclusion, in this multicenter, observational, long-term study, electrocardiographic findings were useful for risk stratification in patients with ARVD, with repolarization criteria, inferior leads TWI, a precordial QRS amplitude ratio of <= 0.48, and QRS fragmentation constituting valuable variables to predict adverse outcome. (C) 2014 Elsevier Inc. All rights reserved.