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QRS fragmentation is superior to QRS duration in predicting mortality in adults with tetralogy of Fallot

Heart (British Cardiac Society), 2017-05, Vol.103 (9), p.666-671 [Tạp chí có phản biện]

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing ;Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/. ;Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/2016 ;ISSN: 1355-6037 ;EISSN: 1468-201X ;DOI: 10.1136/heartjnl-2016-310068 ;PMID: 27803032

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Nhan đề:
QRS fragmentation is superior to QRS duration in predicting mortality in adults with tetralogy of Fallot
Tác giả: Bokma, Jouke P ; Winter, Michiel M ; Vehmeijer, Jim T ; Vliegen, Hubert W ; van Dijk, Arie P ; van Melle, Joost P ; Meijboom, Folkert J ; Post, Martijn C ; Zwinderman, Aeilko H ; Mulder, Barbara J M ; Bouma, Berto J
Chủ đề: Action Potentials ; Adult ; Arrhythmias, Cardiac - diagnosis ; Arrhythmias, Cardiac - etiology ; Arrhythmias, Cardiac - mortality ; Arrhythmias, Cardiac - physiopathology ; Cardiovascular disease ; Cause of Death ; Chi-Square Distribution ; Congenital diseases ; Electrocardiography ; Female ; Heart Conduction System - physiopathology ; Heart Rate ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Mortality ; Multivariate Analysis ; Netherlands ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Registries ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Tetralogy of Fallot - complications ; Tetralogy of Fallot - diagnosis ; Tetralogy of Fallot - mortality ; Tetralogy of Fallot - physiopathology ; Time Factors ; Young Adult
Là 1 phần của: Heart (British Cardiac Society), 2017-05, Vol.103 (9), p.666-671
Mô tả: BackgroundAlthough QRS duration >180 ms has prognostic value in adults with tetralogy of Fallot (TOF), its sensitivity to predict mortality is low. Fragmented QRS complexes, a simple measurement on ECG, are related to myocardial fibrosis and dysfunction in patients with TOF. Our objective was to determine whether QRS fragmentation predicts major outcomes in TOF.MethodsThis multicentre study included adult patients with TOF from a prospective registry. Notches in the QRS complex in ≥2 contiguous leads on a 12-lead ECG, not related to bundle branch block, were defined as QRS fragmentation, which was classified as none, moderate (≤4 leads) or severe (≥5 leads). The primary and secondary outcomes were all-cause mortality and clinical ventricular arrhythmia, respectively.ResultsA total of 794 adult patients with TOF (median age 27 years, 55% male; 52% no QRS fragmentation, 32% moderate, 16% severe) were included. During long-term (median 10.4 years) follow-up, 46 (6%) patients died and 35 (4%) patients had ventricular arrhythmias. Overall, 10-year survival was 98% in patients without fragmented QRS complexes, 93% in patients with moderate QRS fragmentation and 81% in patients with severe QRS fragmentation. In multivariable Cox hazards regression analysis, extent of QRS fragmentation (HR: 2.24/class, 95% CI 1.48 to 3.40, p<0.001) remained independently predictive for mortality, whereas QRS duration was not predictive (p=0.85). The extent of QRS fragmentation was also independently predictive for ventricular arrhythmia (HR: 2.00/class, 95% CI 1.26 to 3.16, p=0.003).ConclusionsThe extent of QRS fragmentation is superior to QRS duration in predicting mortality in adult patients with TOF and may be used in risk stratification.
Nơi xuất bản: England: BMJ Publishing Group LTD
Ngôn ngữ: English
Số nhận dạng: ISSN: 1355-6037
EISSN: 1468-201X
DOI: 10.1136/heartjnl-2016-310068
PMID: 27803032
Nguồn: MEDLINE
ProQuest Central

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QRS fragmentation is superior to QRS duration in predicting mortality in adults with tetralogy of Fallot

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