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@article{1859440, author = {Pelli, Ari and Junttila, Juhani M. and Kenttä, Tuomas V. and Schlögl, Simon and Zabel, Markus and Malík, Marek and Reichlin, Tobias and Willems, Rik and Vos, Marc A. and Harden, Markus and Friede, Tim and Sticherling, Christian and Huikuri, Heikki V}, article_location = {Oxford}, article_number = {5}, doi = {http://dx.doi.org/10.1093/europace/euab260}, keywords = {Implantable cardioverter-defibrillator; Primary prevention; Mortality; Appropriate shock; Benefit; Heart failure; Electrocardiogram; Q wave; QT interval}, language = {eng}, issn = {1099-5129}, journal = {EP Europace}, title = {Q waves are the strongest electrocardiographic variable associated with primary prophylactic implantable cardioverter-defibrillator benefit: a prospective multicentre study}, url = {https://academic.oup.com/europace/article/24/5/774/6446242?login=true}, volume = {24}, year = {2022} }
TY - JOUR ID - 1859440 AU - Pelli, Ari - Junttila, Juhani M. - Kenttä, Tuomas V. - Schlögl, Simon - Zabel, Markus - Malík, Marek - Reichlin, Tobias - Willems, Rik - Vos, Marc A. - Harden, Markus - Friede, Tim - Sticherling, Christian - Huikuri, Heikki V PY - 2022 TI - Q waves are the strongest electrocardiographic variable associated with primary prophylactic implantable cardioverter-defibrillator benefit: a prospective multicentre study JF - EP Europace VL - 24 IS - 5 SP - 774-783 EP - 774-783 PB - Oxford University Press SN - 10995129 KW - Implantable cardioverter-defibrillator KW - Primary prevention KW - Mortality KW - Appropriate shock KW - Benefit KW - Heart failure KW - Electrocardiogram KW - Q wave KW - QT interval UR - https://academic.oup.com/europace/article/24/5/774/6446242?login=true N2 - Aim The association of standard 12-lead electrocardiogram (ECG) markers with benefits of the primary prophylactic implantable cardioverter-defibrillator (ICD) has not been determined in the contemporary era. We analysed traditional and novel ECG variables in a large prospective, controlled primary prophylactic ICD population to assess the predictive value of ECG in terms of ICD benefit. Methods and results Electrocardiograms from 1477 ICD patients and 700 control patients (EU-CERT-ICD; non-randomized, controlled, prospective multicentre study; ClinicalTrials.gov Identifier: NCT02064192), who met ICD implantation criteria but did not receive the device, were analysed. The primary outcome was all-cause mortality. In ICD patients, the co-primary outcome of first appropriate shock was used. Mean follow-up time was 2.4 +/- 1.1 years to death and 2.3 +/- 1.2 years to the first appropriate shock. Pathological Q waves were associated with decreased mortality in ICD patients [hazard ratio (HR) 0.54, 95% confidence interval (CI) 0.35-0.84; P < 0.01] and patients with pathological Q waves had significantly more benefit from ICD (HR 0.44, 95% CI 0.21-0.93; P = 0.03). QTc interval increase taken as a continuous variable was associated with both mortality and appropriate shock incidence, but commonly used cut-off values, were not statistically significantly associated with either of the outcomes. Conclusion Pathological Q waves were a strong ECG predictor of ICD benefit in primary prophylactic ICD patients. Excess mortality among Q wave patients seems to be due to arrhythmic death which can be prevented by ICD. ER -
PELLI, Ari, Juhani M. JUNTTILA, Tuomas V. KENTTÄ, Simon SCHLÖGL, Markus ZABEL, Marek MALÍK, Tobias REICHLIN, Rik WILLEMS, Marc A. VOS, Markus HARDEN, Tim FRIEDE, Christian STICHERLING a Heikki V HUIKURI. Q waves are the strongest electrocardiographic variable associated with primary prophylactic implantable cardioverter-defibrillator benefit: a prospective multicentre study. \textit{EP Europace}. Oxford: Oxford University Press, 2022, roč.~24, č.~5, s.~774-783. ISSN~1099-5129. Dostupné z: https://dx.doi.org/10.1093/europace/euab260.
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