Key result
QTVI ≥80th percentile predicts ~360% higher SCD risk in asymptomatic mild-to-moderate LV dysfunction.
Why the study?
Left ventricular ejection fractions between 35 and 40% raise concern for sudden death, but whether short-term ECG indices of QT variability predict sudden death in these patients was unclear.
Does QT variability index predict sudden cardiac death and total mortality in asymptomatic subjects with post-ischaemic cardiomyopathy and LVEF 35-40%?
Population
396 subjects with CHF from post-ischaemic cardiomyopathy, EF between 35 and 40%, and NYHA class I
Comparison
QT variability indices assessed from a 5 min ECG recording
Design
Prospective study
Follow-up
5 years
Authors
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Supports repolarization variability indices for refining SCD risk in post-MI patients with LVEF 35–40%; extends EF-based stratification in randomized evidence.
Cohort (n=396)
Does QT variability index predict sudden cardiac death and total mortality in asymptomatic subjects with post-ischaemic cardiomyopathy and LVEF 35-40%?
Effect estimate: HR 4.6 (95% CI 1.5-13.4)
p-value: p=0.006
The QT variability index (QTVI) strongly predicts sudden cardiac death and total mortality in asymptomatic patients with post-ischemic cardiomyopathy and mildly depressed ejection fraction (35-40%).
Piccirillo et al. (2006) conducted a cohort in Chronic heart failure due to post-ischaemic cardiomyopathy (n=396). QT variability index (QTVI) ≥80th percentile vs. QTVI <80th percentile was evaluated on Sudden cardiac death (SCD) (HR 4.6, 95% CI 1.5-13.4, p=0.006). A QT variability index (QTVI) ≥80th percentile strongly predicted sudden cardiac death in asymptomatic patients with mild-to-moderate LV systolic dysfunction (HR 4.6; 95% CI 1.5-13.4; P=0.006).
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