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2021, Number 4

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Rev Cubana Cardiol Cir Cardiovasc 2021; 27 (4)

Electrocardiographic predictors of appropriate implantable cardioverter defibrillator therapy

Cruz CM, Gordón FDP, Gutierrez LA, Mengana A

Language: Spanish
References: 40
Page: 1-9
PDF size: 570.73 Kb.


ABSTRACT

Introduction: The identification of appropriate implantable cardioverter defribillator therapy predictors allows for a better risk stratification for sudden cardiac death.
Objectives: Determine the electrocardiografic predictors of appropriate cardioverter defribillator therapy.
Method: A longitudinal prospective study of 38 patients with cardioverter defribillator implanted for the first time, in two tertiary level health care settings between January 2017 and March 2020. In pre-implantation electrocardiogram, the following variables were analyzed: QT interval, QT interval dispersion, QRS fragmentation (QRSf), T wave peak-to-end interval (Tp-e), Tp-e dispersion (dTp-e), QRS width and QRS dispersion. The appropriate therapy (shock and/or anti-tachycardic therapy) was the follow-up variable, with a mean of 35.4 ± 15,5 months.
Results: QRSf (RR 6,260, CI 95% 1,558-25,147; p=0,010) and dTp-e (RR 1,069, CI 95 % 1,005-1,137; p=0,033) were independent predictors of appropriate therapy. The Tp-e and dTp-e ROC showed an area under curve of (0,742, CI 95 % 0,561-0,923; p=0,018) and (0,724 CI 95 % 0,541-0,908; p= 0,028) respectively. A 90ms Tp-e had a sensitivity of 75% and specificity of 73.1% and a 30ms dTp-e had a 66.7% sensitivity and 76.9% in predicting appropriate therapy. The accumulated survival free of appropriate therapy is statistically less in patients with Tp-e ≥ 90ms (p= 0,0031), dTp-e ≥ 30 ms (p= 0,0031) and with fQRS (p= 0,0031).
Conclusions: fQRS, Tp-e and their dispersions are predictors of appropriate cardioverter defribillator therapy.


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