QRS complex and T wave planarity for the efficacy prediction of automatic implantable defibrillators

HNATKOVA, Katerina, Irena ANDRŠOVÁ, Tomáš NOVOTNÝ, Bert VANDERBERK, David SPRENKELER, Juhani JUNTTILA, Tobias REICHLIN, Simon SCHLOEGL, Marc A VOS, Tim FRIEDE, Axel BAUER, Heikki V HUIKURI, Rik WILLEMS, Georg SCHMIDT, Christian STICHERLING, Markus ZABEL a Marek MALÍK. QRS complex and T wave planarity for the efficacy prediction of automatic implantable defibrillators. Heart. London: BMJ Publishing Group, 2024, roč. 110, č. 3, s. 178-187. ISSN 1355-6037. Dostupné z: https://dx.doi.org/10.1136/heartjnl-2023-322878.

Základní údaje

• Originální název: QRS complex and T wave planarity for the efficacy prediction of automatic implantable defibrillators
• Autoři: HNATKOVA, Katerina (203 Česká republika), Irena ANDRŠOVÁ (203 Česká republika, domácí), Tomáš NOVOTNÝ (203 Česká republika, domácí), Bert VANDERBERK, David SPRENKELER, Juhani JUNTTILA, Tobias REICHLIN, Simon SCHLOEGL, Marc A VOS, Tim FRIEDE, Axel BAUER, Heikki V HUIKURI, Rik WILLEMS, Georg SCHMIDT, Christian STICHERLING, Markus ZABEL a Marek MALÍK (203 Česká republika, domácí).
• Vydání: Heart, London, BMJ Publishing Group, 2024, 1355-6037.

Další údaje

• Originální jazyk: angličtina
• Typ výsledku: Článek v odborném periodiku
• Obor: 30201 Cardiac and Cardiovascular systems
• Stát vydavatele: Velká Británie a Severní Irsko
• Utajení: není předmětem státního či obchodního tajemství
• WWW: URL
• Impakt faktor: Impact factor: 5.700 v roce 2022
• Organizační jednotka: Lékařská fakulta
• Doi: http://dx.doi.org/10.1136/heartjnl-2023-322878
• UT WoS: 001070694100001
• Klíčová slova anglicky: Defibrillators; Implantable; Biomarkers; Electrocardiography
• Štítky: 14110211, rivok
• Příznaky: Mezinárodní význam, Recenzováno

Anotace

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.

Návaznosti

• MUNI/A/1412/2022, interní kód MU: Název: Nevyřešené otázky a nové metody hodnocení elektrokardiografického signálu a struktur myokardu

Investor: Masarykova univerzita, Nevyřešené otázky a nové metody hodnocení elektrokardiografického signálu a struktur myokardu