QT interval extracted from 30-minute short resting Holter ECG recordings predicts mortality in heart failure

Αρσένος, Πέτρος; Gatzoulis, Konstantinos; Laina, Ageliki; Doundoulakis, Ioannis; Stergios, Soulaidopoulos; Kordalis, Athanasios; Oikonomou, G; Triantafyllou, Konstantinos; Fragakis, Nikolaos; Vasilikos, Vasillios; Tsioufis, Κonstantinos

doi:10.1016/j.jelectrocard.2022.03.013

Cited by 7 publications

(10 citation statements)

References 33 publications

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“…On the one hand, it can also analyze the relationship between ST fuctuation and time, monitor the changes in patients' hemodynamics, and determine the lesion site to determine whether the patient is asymptomatic myocardial ischemia [12]. On the other hand, in the diagnosis of arrhythmia, it is possible to understand the characteristics of arrhythmia occurrence, duration, attack frequency, etc., to clarify the type of disease, to efectively improve the detection rate, to provide a scientifc basis for clinical treatment and diagnosis, and to take preventive measures as soon as possible [13]. Te results of this study showed that the diagnostic efect of 24 h dynamic electrocardiography was better than that of conventional electrocardiography, and the detection rate of arrhythmia types was also signifcantly higher than that of conventional electrocardiography, indicating that the diagnostic efect of 24 h dynamic electrocardiography was more advantageous.…”

Section: Discussionmentioning

confidence: 99%

Application of 24 h Dynamic Electrocardiography in the Diagnosis of Asymptomatic Myocardial Ischemia with Arrhythmia in Elderly Patients with Coronary Heart Disease

Chen

Tan

Liu

et al. 2022

Emergency Medicine International

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Objective. To investigate the application effect of 24 h dynamic electrocardiogram in the diagnosis of asymptomatic myocardial ischemia with arrhythmia in elderly patients with coronary heart disease. Methods. A total of 206 elderly patients suspected of coronary heart disease (CHD) with asymptomatic myocardial ischemia and arrhythmia were selected as the research subjects. 24 h dynamic electrocardiogram and conventional electrocardiogram examinations were conducted. Coronary angiography was used as the gold standard to observe the performance of the two examination methods in the diagnosis of asymptomatic myocardial ischemia with arrhythmia in elderly patients with CHD. Results. Coronary angiography showed 174 positive cases and 32 negative cases among the 206 patients. The diagnostic results of a conventional electrocardiogram showed 150 positive cases and 20 negative cases. Its sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 86.21%, 62.50%, 82.52%, 92.59%, and 45.45%, respectively. The diagnostic results of 24 h dynamic electrocardiograms showed 168 positive cases and 29 negative cases. Its sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 96.55%, 96.63%, 95.63%, 98.25%, and 82.86%, respectively. The above results indicated that 24 h dynamic electrocardiogram was significantly better ( P < 0.05 ). The detection rate of arrhythmia types by 24-hour dynamic electrocardiogram was significantly higher than that of conventional electrocardiogram ( P < 0.05 ). Conclusion. 24 h dynamic electrocardiogram is helpful for the diagnosis of asymptomatic myocardial ischemia with arrhythmia in elderly patients with CHD and can improve the detection rate, thereby providing a basis for clinical diagnosis and treatment.

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Section: Discussionmentioning

confidence: 99%

Application of 24 h Dynamic Electrocardiography in the Diagnosis of Asymptomatic Myocardial Ischemia with Arrhythmia in Elderly Patients with Coronary Heart Disease

Chen

Tan

Liu

et al. 2022

Emergency Medicine International

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“…Noninvasive ECG parameters are usually assessed in long-term, mainly 24-h recordings. However, data supporting the prognostic role of SHR also exist (Arsenos et al, 2018(Arsenos et al, , 2022Berkowitsch et al, 2004;Rizas et al, 2018). We decided to perform 45-min recordings as a representative short time period considering both feasibility and the acquisition of sufficient rhythm assessment based on existing literature.…”

Section: Discussionmentioning

confidence: 99%

“…These noninvasive ECG indices are routinely measured in long-duration (usually 24 h) ambulatory Holter ECG recordings. However, shortduration ECG recordings, ranging from 5 min to a few hours, have also been used, with promising results (Arsenos et al, 2018(Arsenos et al, , 2022Berkowitsch et al, 2004;Couderc et al, 2007;La Rovere et al, 2003;Mewton et al, 2016;Rizas et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Risk assessment of post‐myocardial infarction patients with preserved ejection fraction using 45‐min short resting Holter electrocardiographic recordings

Triantafyllou,

Fragakis,

Gatzoulis

et al. 2023

Noninvasive Electrocardiol

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BackgroundRisk stratification for sudden cardiac death in post‐myocardial infarction (post‐MI) patients remains a challenging task. Several electrocardiographic noninvasive risk factors (NIRFs) have been associated with adverse outcomes and were used to refine risk assessment. This study aimed to evaluate the performance of NIRFs extracted from 45‐min short resting Holter ECG recordings (SHR), in predicting ventricular tachycardia inducibility with programmed ventricular stimulation (PVS) in post‐MI patients with preserved left ventricular ejection fraction (LVEF).MethodsWe studied 99 post‐MI ischemia‐free patients (mean age: 60.5 ± 9.5 years, 86.9% men) with LVEF ≥40%, at least 40 days after revascularization. All the patients underwent PVS and a high‐resolution SHR. The following parameters were evaluated: mean heart rate, ventricular arrhythmias (premature ventricular complexes, couplets, tachycardias), QTc duration, heart rate variability (HRV), deceleration capacity, heart rate turbulence, late potentials, and T‐wave alternans.ResultsPVS was positive in 24 patients (24.2%). HRV, assessed by the standard deviation of normal‐to‐normal R–R intervals (SDNN), was significantly decreased in the positive PVS group (42 ms vs. 51 ms, p = .039). SDNN values <50 ms were also associated with PVS inducibility (OR 3.081, p = .032 in univariate analysis, and 4.588, p = .013 in multivariate analysis). No significant differences were identified for the other NIRFs. The presence of diabetes, history of ST‐elevation MI (STEMI) and LVEF <50% were also important predictors of positive PVS.ConclusionsHRV assessed from SHR, combined with other noninvasive clinical and echocardiographic variables (diabetes, STEMI history, LVEF), can provide an initial, practical, and rapid screening tool for arrhythmic risk assessment in post‐MI patients with preserved LVEF.

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“…Page et al [ 16 ] showed that failure of the QT to adapt to changes in heart rate was associated with a higher risk of symptoms, building on the concept of the “QT clock”, where different genotypes demonstrate phenotype-specific QT rate behavior [ 9 ]. Holter measurements of QT interval and minor T wave alternans are also linked to adverse outcomes in adult patients with heart failure [ 17 , 18 ], even when limited to only 30 min recordings [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Holter Recordings at Initial Assessment for Long QT Syndrome: Relationship to Genotype Status and Cardiac Events

Waddell-Smith

Chaptynova

et al. 2022

JCDD

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Background: The relationship of Holter recordings of repolarization length to outcome in long QT syndrome (LQTS) is unknown. Methods: Holter recordings and initial 12 lead ECG QTc were related to outcome in 101 individuals with LQTS and 28 gene-negative relatives. Mean QTc (mQTc) and mean RTPc (R-wave to peak T-wave, mRTPc) using Bazett correction were measured, analyzing heart rates 40 to 120 bpm. Previously reported upper limit of normal (ULN) were: women and children (<15 years), mQTc 454, mRTPc 318 ms; men mQTc 446 ms, mRTPc 314 ms. Results: Measurements in LQTS patients were greatly prolonged; children and women mean mQTc 482 ms (range 406–558), mRTPc 351 ms (259–443); males > 15 years mQTc 469 ms (407–531), mRTPc 338 ms (288–388). Ten patients had cardiac arrest (CA), and 24 had arrhythmic syncope before or after the Holter. Holter values were more closely related to genotype status and symptoms than 12 lead QTc, e.g., sensitivity/specificity for genotype positive status, mRTPc > ULN (89%/86%); CA, mRTPc > 30 ms over ULN (48%/100%). Of 34 symptomatic (CA/syncope) patients, only 9 (26%) had 12 lead QTc > 500 ms, whereas 33/34 (94%) had an mRTPc or mQTc above ULN. In 10 with CA, all Holter measurements were > 15 ms above ULN, but only two had 12 lead QTc > 500 m. Conclusions: Holter average repolarization length, particularly mRTPc, reflects definite LQTS status and clinical risk better than the initial 12 lead QTc. Values below ULN indicate both a low risk of having LQTS and a low risk of cardiac events in the small percentage that do.

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QT interval extracted from 30-minute short resting Holter ECG recordings predicts mortality in heart failure

Cited by 7 publications

References 33 publications

Application of 24 h Dynamic Electrocardiography in the Diagnosis of Asymptomatic Myocardial Ischemia with Arrhythmia in Elderly Patients with Coronary Heart Disease

Application of 24 h Dynamic Electrocardiography in the Diagnosis of Asymptomatic Myocardial Ischemia with Arrhythmia in Elderly Patients with Coronary Heart Disease

Risk assessment of post‐myocardial infarction patients with preserved ejection fraction using 45‐min short resting Holter electrocardiographic recordings

Holter Recordings at Initial Assessment for Long QT Syndrome: Relationship to Genotype Status and Cardiac Events

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