Electrocardiographic Preexcitation and Risk of Cardiovascular Morbidity and Mortality

Skov, Marianne; Rasmussen, Peter; Ghouse, Jonas; Hansen, Steen Møller; Graff, Claus; Olesen, Morten S.; Pietersen, Adrian; Torp‐Pedersen, Christian; Haunsø, Stig; Køber, Lars; Svendsen, Jesper Hastrup; Holst, Anders G.; Nielsen, Jonas B.

doi:10.1161/circep.116.004778

Cited by 21 publications

(27 citation statements)

References 33 publications

(25 reference statements)

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“…At an older age, symptoms can be more serious, such as presyncope and syncope [13]. SVTs are generally not life-threatening, but some specific situations (in patients with WPW syndrome and AF or after atrial switch operation) can cause sudden cardiac death [14, 15].…”

Section: Clinical Findings and Initial Evaluationmentioning

confidence: 99%

What Have We Learned from the European Society of Cardiology 2019 Guidelines on Supraventricular Tachycardia

Babayiğit¹,

Ulus

Görenek

2020

Cardiology

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Supraventricular tachycardias (SVTs) are common arrhythmic conditions in clinical practice. Increased knowledge and experience on SVTs and some unclear situations in clinical practice led the European Society of Cardiology (ESC) team to write a new guideline. In this review, we touch upon the important points in the new ESC 2019 SVT guidelines and present changing approaches and suggestions. By providing a general review on SVTs, we also mention the basic mechanism, epidemiology, and clinical presentation of SVTs, approaching narrow and wide QRS tachycardias, SVTs in special patient groups, and treatment of SVTs.

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Section: Clinical Findings and Initial Evaluationmentioning

confidence: 99%

What Have We Learned from the European Society of Cardiology 2019 Guidelines on Supraventricular Tachycardia

Babayiğit¹,

Ulus

Görenek

2020

Cardiology

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“…ECG changes can be found in different stages of COPD and can be associated with the increased death risk. An increased burden of cardiac arrhythmias has also been recognized recently [5]. In COPD, various mechanisms can influence ECG diversely, independent of a possibly CAD [6].…”

Section: Introductionmentioning

confidence: 99%

“…Along with pulmonary involvement, there are significant extra pulmonary effects in COPD [3,4,5]. COPD can influence electrocardiographic (ECG) changes variously.…”

Section: Introductionmentioning

confidence: 99%

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Electrocardiographic predictors of five-years mortality in chronic obstructive pulmonary disease patients

et al. 2021

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Introduction/Objective. Cardiovascular disease is one of the most common comorbidities among subjects with chronic obstructive pulmonary disease (COPD). The aim of this study is to evaluate ECG parameters and mortality predictors in COPD patients. Methods. A total of 835 consecutive patients were included. Patients were classified to suffer from COPD if in three consecutive postbronhodilatator measurements FEV1/FVC was <70%. Following ECG changes were observed: axis, p wave, low ORS complex, transitional zone, left bundle branch block (LBBB), right bundle branch block (RBBB), incomplete right bundle branch block, S1S2S3 configuration, negative T in V1-V3. Patients were followed up for mortality in a five years period. Results. Both survivors and non-survivors were similar age, gender and COPD status. FVC and FEV1 as well as GOLD stadium are significantly higher in surviving group (p<0.016, p<0.001, p<0.001 respectively). Normal axis was in significantly higher percentage in non-survived patients (p=0.020). Right RBBB and incomplete RBB are more frequent finding in patients who died as (p?0.001, p?0.05, respectively). LBBB, S1S2S3 configuration is in significantly higher percent in non survivors (p<0.016, p<0.001, respectively). In multivariable logistic model, patients with LBBB have two times higher chance of mortality compared to patients without LBBB. Contrary, patients with RBBB have 1.6 times lower chance to have death outcome. Conclusion. Main ECG predictors of COPD patients? five-year mortality are LBBB and RBBB, but according to statistical model, electrocardiogram should be further explored and possibly obligatory involved in a routine clinical practice as an easy and low-cost screening method.

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“…Moreover, patients aged 65 years or older had a significantly higher risk of death (HR, 1.85) when compared with patients without preexcitation. 23 Stec et al 24 reported a case series of patients with asymptomatic preexcitation with dyspnea and exercise intolerance. No organic disease in the cardiopulmonary system was found.…”

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confidence: 99%

Malignant ventricular arrhythmias and other complications of untreated accessory pathways: an analysis of prevalence and risk factors in over 600 ablation cases

Moskal¹,

Jastrzębski²,

Pitak³

et al. 2020

Kardiol Pol

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BACKGROUND The presence of accessory pathways (APs) is a risk factor for sudden cardiac death and other clinical complications. AIMS We aimed to characterize all adverse events likely related to the presence of APs in patients referred for AP ablation and to identify risk factors for malignant arrhythmias. METHODS We performed a retrospective analysis of consecutive patients referred for AP ablation from 2002 to 2017. Electrocardiograms, electrophysiological system records, and hospital discharge notes were reviewed. We collected data concerning symptoms before ablation, occurrence of ventricular fibrillation or malignant atrial fibrillation (AF), as well as other complications related to APs. RESULTS We identified 602 patients with APs. Serious AP-related events were observed in 41 patients, including 14 sudden cardiac arrests (1 death) and 16 pre-cardiac arrest events. Other complications included strokes, pulmonary edema, heart failure, and unnecessary device implantation. The risk of malignant arrhythmias decreased with a longer shortest preexcited RR interval (per 10 ms: odds ratio [OR], 1.3; 95% CI, 1.16-1.47) and increased with age (per 10 years: OR, 1.29; 95% CI, 1.06-1.57). The presence of inducible AF, but not sole atrioventricular reentrant tachycardia, increased the risk for malignant arrhythmias when compared with patients without any inducible arrhythmias. CONCLUSIONS Patients with APs referred for ablation commonly present with various adverse events. The predictive value of clinical risk factors for malignant arrhythmias is too low to prevent devastating consequences. When high safety and efficacy of AP ablation are ensured, even a low risk of sudden death is unacceptable and a lower threshold for prophylactic ablation should be used to prevent AP-related adverse events.

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Electrocardiographic Preexcitation and Risk of Cardiovascular Morbidity and Mortality

Cited by 21 publications

References 33 publications

What Have We Learned from the European Society of Cardiology 2019 Guidelines on Supraventricular Tachycardia

What Have We Learned from the European Society of Cardiology 2019 Guidelines on Supraventricular Tachycardia

Electrocardiographic predictors of five-years mortality in chronic obstructive pulmonary disease patients

Malignant ventricular arrhythmias and other complications of untreated accessory pathways: an analysis of prevalence and risk factors in over 600 ablation cases

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