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

J 2024

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

HNATKOVA, Katerina, Irena ANDRŠOVÁ, Tomáš NOVOTNÝ, Bert VANDERBERK, David SPRENKELER et. al.

Basic information

Original name

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

Authors

HNATKOVA, Katerina (203 Czech Republic), Irena ANDRŠOVÁ (203 Czech Republic, belonging to the institution), Tomáš NOVOTNÝ (203 Czech Republic, belonging to the institution), 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 and Marek MALÍK (203 Czech Republic, belonging to the institution)

Edition

Heart, London, BMJ Publishing Group, 2024, 1355-6037

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: 5.700 in 2022

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1136/heartjnl-2023-322878

UT WoS

001070694100001

Keywords in English

Defibrillators; Implantable; Biomarkers; Electrocardiography

Abstract

V originále

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.

Links

MUNI/A/1412/2022, interní kód MU

Name: Nevyřešené otázky a nové metody hodnocení elektrokardiografického signálu a struktur myokardu

Investor: Masaryk University

Citovat

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 and Marek MALÍK. QRS complex and T wave planarity for the efficacy prediction of automatic implantable defibrillators. Heart. London: BMJ Publishing Group, 2024, vol. 110, No 3, p. 178-187. ISSN 1355-6037. Available from: https://dx.doi.org/10.1136/heartjnl-2023-322878.

@article{2370279,
   author = {Hnatkova, Katerina and Andršová, Irena and Novotný, Tomáš and Vanderberk, Bert and Sprenkeler, David and Junttila, Juhani and Reichlin, Tobias and Schloegl, Simon and Vos, Marc A and Friede, Tim and Bauer, Axel and Huikuri, Heikki V and Willems, Rik and Schmidt, Georg and Sticherling, Christian and Zabel, Markus and Malík, Marek},
   article_location = {London},
   article_number = {3},
   doi = {http://dx.doi.org/10.1136/heartjnl-2023-322878},
   keywords = {Defibrillators; Implantable; Biomarkers; Electrocardiography},
   language = {eng},
   issn = {1355-6037},
   journal = {Heart},
   title = {QRS complex and T wave planarity for the efficacy prediction of automatic implantable defibrillators},
   url = {https://heart.bmj.com/content/110/3/178},
   volume = {110},
   year = {2024}
}

TY  - JOUR
ID  - 2370279
AU  - Hnatkova, Katerina - Andršová, Irena - Novotný, Tomáš - Vanderberk, Bert - Sprenkeler, David - Junttila, Juhani - Reichlin, Tobias - Schloegl, Simon - Vos, Marc A - Friede, Tim - Bauer, Axel - Huikuri, Heikki V - Willems, Rik - Schmidt, Georg - Sticherling, Christian - Zabel, Markus - Malík, Marek
PY  - 2024
TI  - QRS complex and T wave planarity for the efficacy prediction of automatic implantable defibrillators
JF  - Heart
VL  - 110
IS  - 3
SP  - 178-187
EP  - 178-187
PB  - BMJ Publishing Group
SN  - 13556037
KW  - Defibrillators
KW  - Implantable
KW  - Biomarkers
KW  - Electrocardiography
UR  - https://heart.bmj.com/content/110/3/178
N2  - 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.
ER  -

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 and Marek MALÍK. QRS complex and T wave planarity for the efficacy prediction of automatic implantable defibrillators. \textit{Heart}. London: BMJ Publishing Group, 2024, vol.~110, No~3, p.~178-187. ISSN~1355-6037. Available from: https://dx.doi.org/10.1136/heartjnl-2023-322878.

Detailed Information on Publication Record