Task Force on Sudden Cardiac Death of the European Society of Cardiology

Priori, Silvia G.; Aliot, Étienne; Blomström‐Lundqvist, Carina; Bossaert, Leo; Breithardt, Günter; Brugada, Pedro; Camm, A. John; Cappato, Riccardo; Cobbe, Stuart M.; Mario, Carlo Di; Maron, Barry J.; McKenna, William J.; Pedersen, Anders Kirstein; Ravens, Ursula; Schwartz, Peter J.; Trusz‐Gluza, Maria; Vardas, Panos; Wellens, Hein J.J.; Zipes, Douglas P.

doi:10.1053/euhj.2001.2824

Cited by 771 publications

(523 citation statements)

References 594 publications

(737 reference statements)

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“…The predictive power of conventional HRV measures may be absorbed by the associations between these clinical risk factors and cardiac vagal dysfunction (6,7).…”

Section: Discussionmentioning

confidence: 99%

Nonlinear Measures of Heart Rate Variability and Mortality Risk in Hemodialysis Patients

Suzuki

Aoyama

Tanaka

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Nonlinear measures of heart rate variability (HRV) have gained recent interest as powerful risk predictors in various clinical settings. This study examined whether they improve risk stratification in hemodialysis patients.Design, setting, participants, & measurements To assess heart rate turbulence, deceleration capacity, fractal scaling exponent (a 1 ), and other conventional HRV measures, 281 hemodialysis patients underwent 24-hour electrocardiography between January 2002 and May 2004 and were subsequently followed up.Results During a median 87-month follow-up, 77 patients (27%) died. Age, left ventricular ejection fraction, serum albumin, C-reactive protein, and calcium 3 phosphate independently predicted mortality. Whereas all nonlinear HRV measures predicted mortality, only decreased scaling exponent a 1 remained significant after adjusting for clinical risk factors (hazard ratio per a 0.25 decrement, 1.46; 95% confidence interval [95% CI], 1.16-1.85). The inclusion of a 1 into a prediction model composed of clinical risk factors increased the C statistic from 0.84 to 0.87 (P=0.03), with 50.8% (95% CI, 20.2-83.7) continuous net reclassification improvement for 5-year mortality. The predictive power of a 1 showed an interaction with age (P=0.02) and was particularly strong in patients aged ,70 years (n=208; hazard ratio, 1.87; 95% CI, 1.38-2.53), among whom a 1 increased the C statistic from 0.85 to 0.89 (P=0.01), with a 93.1% (95% CI, 59.3-142.0) continuous net reclassification improvement.Conclusions Scaling exponent a 1 that reflects fractal organization of short-term HRV improves risk stratification for mortality when added to the prediction model by conventional risk factors in hemodialysis patients, particularly those aged ,70 years.

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“…The predictive power of conventional HRV measures may be absorbed by the associations between these clinical risk factors and cardiac vagal dysfunction (6,7).…”

Section: Discussionmentioning

confidence: 99%

Nonlinear Measures of Heart Rate Variability and Mortality Risk in Hemodialysis Patients

Suzuki

Aoyama

Tanaka

et al. 2012

Clinical Journal of the American Society of Nephrology

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“…A consensus exists on the indication of an ICD in cardiac arrest survivors, 16,17 yet treatment of the majority of patients with BS is undefined.…”

Section: Risk Stratification In Bsmentioning

confidence: 99%

Natural history of Brugada Syndrome. Insights for risk stratification and management

Priori¹,

Napolitano²,

Gasparini³

2002

ACC Current Journal Review

245

429

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Background-Treatment of patients with Brugada syndrome is complicated by the incomplete information on the natural history of the disease related to the small number of cases reported. Furthermore, the value of programmed electrical stimulation (PES) for risk stratification is highly debated. The objective of this study was to search for novel parameters to identify patients at risk of sudden death. Methods and Results-Clinical data were collected for 200 patients (152 men, 48 women; age, 41Ϯ18 years) and stored in a dedicated database. Genetic analysis was performed, and mutations on the SCN5A gene were identified in 28 of 130 probands and in 56 of 121 family members. The life-table method of Kaplan-Meier used to define the cardiac arrest-free interval in patients undergoing PES failed to demonstrate an association between PES inducibility and spontaneous occurrence of ventricular fibrillation. Multivariate Cox regression analysis showed that after adjusting for sex, family history of sudden death, and SCN5A mutations, the combined presence of a spontaneous ST-segment elevation in leads V 1 through V 3 and the history of syncope identifies subjects at risk of cardiac arrest (HR, 6.4; 95% CI, 1.9 to 21; PϽ0.002). Conclusions-The information on the natural history of patients obtained in this study allowed elaboration of a risk-stratification scheme to quantify the risk for sudden cardiac death and to target the use of the implantable cardioverter-defibrillator.

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“…58 Sports to be avoided are further detailed in a consensus document developed by the American Heart Association. 59 Several teams have demonstrated reductions in QT interval length and T-wave abnormalities in LQT2 patients following intravenous and oral potassium administration, though effects may not be long lasting.…”

Section: Interventionmentioning

confidence: 99%

The long QT syndrome family of cardiac ion channelopathies: A HuGE review

Modell

Lehmann

2006

Genetics in Medicine

146

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Long QT syndrome (LQTS) refers to a group of "channelopathies"-disorders that affect cardiac ion channels. The "family" concept of syndromes has been applied to the multiple LQTS genotypes, LQT1-8, which exhibit converging mechanisms leading to QT prolongation and slowed ventricular repolarization. The 470ϩ allelic mutations induce loss-of-function in the passage of mainly K ϩ ions, and gain-of-function in the passage of Na ϩ ions through their respective ion channels. Resultant early after depolarizations can lead to a polymorphic form of ventricular tachycardia known as torsade de pointes, resulting in syncope, sudden cardiac death, or near-death (i.e., cardiac arrest aborted either spontaneously or with external defibrillation). LQTS may be either congenital or acquired. The genetic epidemiology of both forms can vary with subpopulation depending on the allele, but as a whole, LQTS appears in every corner of the globe. Many polymorphisms, such as HERG P448R and A915V in Asians, and SCN5A

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Task Force on Sudden Cardiac Death of the European Society of Cardiology

Cited by 771 publications

References 594 publications

Nonlinear Measures of Heart Rate Variability and Mortality Risk in Hemodialysis Patients

Nonlinear Measures of Heart Rate Variability and Mortality Risk in Hemodialysis Patients

Natural history of Brugada Syndrome. Insights for risk stratification and management

The long QT syndrome family of cardiac ion channelopathies: A HuGE review

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