QRS complex and T wave planarity for the efficacy prediction of automatic implantable defibrillators
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:110 |
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| Enthalten in: |
Heart (British Cardiac Society) - 110(2024), 3 vom: 10. Jan., Seite 178-187 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hnatkova, Katerina [VerfasserIn] |
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| Links: |
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| Themen: |
Biomarkers |
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| Anmerkungen: |
Date Completed 12.01.2024 Date Revised 10.02.2024 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1136/heartjnl-2023-322878 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM362118353 |
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| 245 | 1 | 0 | |a QRS complex and T wave planarity for the efficacy prediction of automatic implantable defibrillators |
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| 500 | |a Date Revised 10.02.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ. | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Biomarkers | |
| 650 | 4 | |a Defibrillators, Implantable | |
| 650 | 4 | |a Electrocardiography | |
| 700 | 1 | |a Andršová, Irena |e verfasserin |4 aut | |
| 700 | 1 | |a Novotný, Tomáš |e verfasserin |4 aut | |
| 700 | 1 | |a Vanderberk, Bert |e verfasserin |4 aut | |
| 700 | 1 | |a Sprenkeler, David |e verfasserin |4 aut | |
| 700 | 1 | |a Junttila, Juhani |e verfasserin |4 aut | |
| 700 | 1 | |a Reichlin, Tobias |e verfasserin |4 aut | |
| 700 | 1 | |a Schlögl, Simon |e verfasserin |4 aut | |
| 700 | 1 | |a Vos, Marc A |e verfasserin |4 aut | |
| 700 | 1 | |a Friede, Tim |e verfasserin |4 aut | |
| 700 | 1 | |a Bauer, Axel |e verfasserin |4 aut | |
| 700 | 1 | |a Huikuri, Heikki V |e verfasserin |4 aut | |
| 700 | 1 | |a Willems, Rik |e verfasserin |4 aut | |
| 700 | 1 | |a Schmidt, Georg |e verfasserin |4 aut | |
| 700 | 1 | |a Sticherling, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Zabel, Markus |e verfasserin |4 aut | |
| 700 | 1 | |a Malik, Marek |e verfasserin |4 aut | |
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