| Title: | ECG T-Wave Morphologic Variations Predict Ventricular Arrhythmic Risk in Low- and Moderate-Risk Populations |
| Journal: | Journal of the American Heart Association |
| Published: | 29 Aug 2022 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/36036209/ |
| DOI: | https://doi.org/10.1161/jaha.121.025897 |
| URL: | https://www.ahajournals.org/doi/pdf/10.1161/JAHA.121.025897 |
| Citations: | 17 (15 in last 2 years) as of 8 Aug 2024 |
Publication 12259
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Abstract
Background Early identification of individuals at risk of sudden cardiac death (SCD) remains a major challenge. The ECG is a simple, common test, with potential for large-scale application. We developed and tested the predictive value of a novel index quantifying T-wave morphologic variations with respect to a normal reference (TMV), which only requires one beat and a single-lead ECG. Methods and Results We obtained reference T-wave morphologies from 23 962 participants in the UK Biobank study. With Cox models, we determined the association between TMV and life-threatening ventricular arrhythmia in an independent data set from UK Biobank study without a history of cardiovascular events (N=51 794; median follow-up of 122 months) and SCD in patients with coronary artery disease from ARTEMIS (N=1872; median follow-up of 60 months). In UK Biobank study, 220 (0.4%) individuals developed life-threatening ventricular arrhythmias. TMV was significantly associated with life-threatening ventricular arrhythmias (hazard ratio [HR] of 1.13 per SD increase [95% CI, 1.03-1.24]; P=0.009). In ARTEMIS, 34 (1.8%) individuals reached the primary end point. Patients with TMV ≥5 had an HR for SCD of 2.86 (95% CI, 1.40-5.84; P=0.004) with respect to those with TMV <5, independently from QRS duration, corrected QT interval, and left ventricular ejection fraction. TMV was not significantly associated with death from a cause other than SCD. Conclusions TMV identifies individuals at life-threatening ventricular arrhythmia and SCD risk using a single-beat single-lead ECG, enabling inexpensive, quick, and safe risk assessment in large populations.</p>
10 Authors
- Julia Ramírez
- Antti Kiviniemi
- Stefan van Duijvenboden
- Andrew Tinker
- Pier D. Lambiase
- Juhani Junttila
- Juha S. Perkiömäki
- Heikki V. Huikuri
- Michele Orini
- Patricia B. Munroe
1 Application
| Application ID | Title |
|---|---|
| 8256 | Understanding genetic influences in the response of the cardiac electrical system to exercise |
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