Risk score for developing arrhythmia-induced cardiomyopathy in children with idiopathic ventricular arrhythmias based on single center data

Aim. To develop a predictive model and a clinical risk score for developing arrhythmia-induced cardiomyopathy (AIC) in children with idiopathic ventricular arrhythmias (VA). Methods. The study included 492 children aged 1 to 17 years with idiopathic VA. In 392 patients demographic, clinical and diagnostic-related variables were evaluated as potential prognostic factors using binary logistic regression. The scores for each predictor were set based on the odds ratio. Validation of the model was carried out on a test group (n=100). Results. It was found that body surface area ≥ 1,7 m2 increases the ratio of developing AIC by 4,9 times (1 point), the premature ventricular contraction’s coupling interval < 434 ms. - by 3,7 times (1 point), the burden of VA 25-29% - by 8,4 times (2 points), the burden of VA 30-34% - 11,3 times (3 points), the burden of VA ≥ 35% - 17,2 times (4 points). The specificity of the risk score was determined by the ROC curve. A low probability of developing AIC was determined with a score of up to 2 (specificity <48.1%), an average probability was determined with a score 3-4 (specificity 67.5-81.8%), a high probability was determined with a score 5-6, (specificity >95.1%). The AUC of the predictive scale was 0.805±0.037 (95% CI: 0.732-0.878), p<0.001. The AUC of the of the predictive scale in the test group was 0.893±0.034 (95% CI: 0.827-0.96),p<0.001. The difference in the AUC of the scores in training and test groups was 0.088±0.05. The AUCs were comparable (p=0.078). Conclusion. In this study we identified independent predictors of IAC in children with idiopathic VA. A clinical risk scale of AIC has been developed based on the obtained predictors. Routine use of the AIC risk scale will lead to personalized monitoring and treatment of each child with idiopathic VA.