Q waves are the strongest electrocardiographic variable
associated with primary prophylactic implantable
cardioverter-defibrillator benefit: a prospective multicentre
study

J 2022

Q waves are the strongest electrocardiographic variable associated with primary prophylactic implantable cardioverter-defibrillator benefit: a prospective multicentre study

PELLI, Ari, Juhani M. JUNTTILA, Tuomas V. KENTTÄ, Simon SCHLÖGL, Markus ZABEL et. al.

Basic information

Original name

Q waves are the strongest electrocardiographic variable associated with primary prophylactic implantable cardioverter-defibrillator benefit: a prospective multicentre study

Authors

PELLI, Ari, Juhani M. JUNTTILA (guarantor), Tuomas V. KENTTÄ, Simon SCHLÖGL, Markus ZABEL, Marek MALÍK (203 Czech Republic, belonging to the institution), Tobias REICHLIN, Rik WILLEMS, Marc A. VOS, Markus HARDEN, Tim FRIEDE, Christian STICHERLING and Heikki V HUIKURI

Edition

EP Europace, Oxford, Oxford University Press, 2022, 1099-5129

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 6.100

RIV identification code

RIV/00216224:14110/22:00125980

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1093/europace/euab260

UT WoS

000790073500001

Keywords in English

Implantable cardioverter-defibrillator; Primary prevention; Mortality; Appropriate shock; Benefit; Heart failure; Electrocardiogram; Q wave; QT interval

Abstract

V originále

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.

Citovat

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 and Heikki V HUIKURI. Q waves are the strongest electrocardiographic variable associated with primary prophylactic implantable cardioverter-defibrillator benefit: a prospective multicentre study. EP Europace. Oxford: Oxford University Press, 2022, vol. 24, No 5, p. 774-783. ISSN 1099-5129. Available from: https://dx.doi.org/10.1093/europace/euab260.

@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 and 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, vol.~24, No~5, p.~774-783. ISSN~1099-5129. Available from: https://dx.doi.org/10.1093/europace/euab260.

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