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ISSN 1561-2937 (Impreso)

2021, Número 4

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Rev Cubana Cardiol Cir Cardiovasc 2021; 27 (4)


Predictores electrocardiográficos de terapias apropiadas del cardiodesfibrilador automático implantable

Cruz CM, Gordón FDP, Gutierrez LA, Mengana A

Idioma: Español
Referencias bibliográficas: 40
Paginas: 1-9
Archivo PDF: 570.73 Kb.


RESUMEN

Introducción: La identificación de predictores de terapias apropiadas del cardiodesfibrilador automático implantable permite mejorar la estratificación de riesgo de muerte súbita cardíaca.
Objetivo: Determinar predictores electrocardiográficos de terapias apropiadas del cardiodesfibrilador.
Método: Estudio longitudinal prospectivo en 38 pacientes con primoimplante de cardiodesfibrilador en dos centros de atención terciaria de salud, en el periodo enero 2017 a marzo 2020. En electrocardiograma previo al implante se analizaron las variables: intervalo QT, dispersión del intervalo QT, fragmentación QRS (fQRS), intervalo pico-final onda T(Tp-f), dispersión del Tp-f (dTp-f), anchura del QRS y dispersión del QRS. La terapia apropiada (choque y/o terapia antitaquicardia) fue la variable de seguimiento, con media de 35,4  15,5 meses.
Resultados: La fQRS (RR 6,260, IC 95 % 1,558-25,147; p=0,010) y la dTp-f (RR 1,069, IC 95 % 1,005-1,137; p=0,033) fueron predictores independiente de terapias apropiadas. La curva ROC del Tp-f y dTp-f mostraron áreas bajo la curva de (0,742, IC 95 % 0,561-0,923; p=0,018) y (0,724 IC 95 % 0,541-0,908; p= 0,028); respectivamente. Tp-f de 90 ms mostró sensibilidad 75 % y especificidad de 73,1 % y dTp-f de 30 ms sensibilidad 66,7 % y especificidad 76,9 % para predecir terapias apropiadas. La supervivencia acumulada libre de terapias apropiadas es estadísticamente menor en los pacientes con Tp-f ≥ 90ms (p= 0,0031), dTp-f ≥ 30 ms (p= 0,0031) y con fQRS (p= 0,0031).
Conclusiones: La fQRS y el Tp-f y su dispersión son predictores de terapias apropiadas del cardiodesfibrilador.


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