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

Autori
Pelli, Ari ; Junttila, M Juhani ; Kenttä, Tuomas V ; Schlögl, Simon ; Zabel, Markus ; Malik, Marek ; Reichlin, Tobias ; Willems, Rik ; Vos, Marc A ; Harden, Markus ; Friede, Tim ; Sticherling, Christian ; Huikuri, Heikki V ; Arbelo, Elena ; Bauer, Axel ; Braunschweig, Frieder ; Brugada, Josep ; Conen, David ; Cygankiewicz, Iwona ; Dommasch, Michael ; Eick, Christian ; Flevari, Panagiota ; Friede, Tim ; Galuszka, Jan ; Hansen, Jim ; Hatala, Robert ; Harden, Markus ; Hnatkova, Katerina ; Huikuri, Heikki V ; Junttila, Juhani M ; Kääb, Stefan ; Kaliska, Gabriela ; Kasprzak, Jaroslaw D ; Katsimardos, Andreas ; Kozak, Milan ; Kuczejko, Tomasz ; Lubinski, Andrzej ; Martinek, Jozef ; Merkely, Béla ; Novotný, Tomáš ; Malik, Marek ; Perge, Peter ; Pieske, Burkert ; Platonov, Pyotr ; Ptaczyński, Pawel ; Qavoq, Dariusz ; Rotkvić, L ; Sallo, Zoltan ; Schlögl, Simon ; Schmidt, Georg ; Sinner, Moritz ; Sritharan, Rajeeva ; Stefanow, Stefan ; Sticherling, Christian ; Svendsen, Jesper Hastrup ; Svetlosak, Martin ; Szavits-Nossan, Janko ; Taborsky, Milos ; Tuinenburg, Anton ; Vandenberk, Bert ; Vos, Marc A ; Willems, Rik ; Willich, Stefan N ; Wolpert, Christian ; Zabel, Markus ; Anic, Ante ; Bakotic, Zoran ; Behrens, Steffen ; Bimmel, Dieter ; Brusich, Sandro ; Dissmann, Rüdiger ; Grönefeld, Gerian ; Guzik, Przemyzlav ; Iovev, Svetoslav ; Jurisic, Zrinka ; Klingenheben, Thomas ; Pavlović, Nikola ; Seegers, Joachim ; Schwinger, Robert H G ; Shalganov, Tchavdar ; Traykov, Vassil ; Velchev, Vasil ; the EU-CERT-ICD Study Investigators

Izvornik
EP Europace (1099-5129) 24 (2021), 5; 774-783

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

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

Sažetak
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.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA