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@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.
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