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Circ Arrhythm Electrophysiol 2013 Dec 1;6(6):1156-62

Screening Entire Health System ECG Databases to Identify Patients at Increased Risk of Death.

Strauss DG, Mewton N, Verrier RL, Nearing BD, Marchlinski FE, Killian T, Moxley J, Tereshchenko LG, Wu KC, Winslow RL, Cox C, Spooner PM, Lima JA

Abstract

BACKGROUND: Current methods to identify patients at higher risk for sudden cardiac death, primarily left ventricular ejection fraction (LVEF) /=5 and QRS-T angle >/=105 degrees identified 8.0% of patients and was associated with an odds ratio (OR) of 2.79 [95% confidence interval 2.10-3.69] for 1-year mortality compared to patients below both ECG thresholds (13.9% vs. 5.5% death rate). LVEF was >35% in 82% of the former group of patients and addition of ECG measures to LVEF increased the discrimination of death risk (p<0.0001). At the second hospital, the OR was 2.42 [1.95-3.01] for 1-year mortality (8.8% vs. 3.8%). Adjustment for patient characteristics eliminated inter-hospital differences. Multivariable adjusted OR combining data from both hospitals was 1.53 [1.28-1.83]. Increasing heart rate and chronic renal impairment further predicted mortality. CONCLUSIONS: Screening hospital ECG databases with QRS scoring and QRS-T angle analysis identifies patients with high 1-year all-cause mortality and predominantly preserved LVEF. This approach may represent a widely-available method to identify patients at increased risk of death.


Category: Journal Article
PubMed ID: #24122522 DOI: 10.1161/CIRCEP.113.000411
Includes FDA Authors from Scientific Area(s): Medical Devices
Entry Created: 2013-10-15 Entry Last Modified: 2014-01-19
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