Key result
Fragmented QRS predicts ~6.7-fold higher arrhythmic risk in NICM, alongside T-wave alternans.
Why the study?
Multiple techniques have been evaluated as predictors of ventricular tachyarrhythmias and sudden death in nonischemic dilated cardiomyopathy, but their comparative performance needed estimation.
Do various risk stratification tests predict arrhythmic events in patients with nonischemic dilated cardiomyopathy?
Meta-Analysis (n=6,088)
Do various risk stratification tests predict arrhythmic events in patients with nonischemic dilated cardiomyopathy?
Effect estimate: OR 6.73 (95% CI 3.85-11.76)
Individual risk stratification tests provide only modest predictive value for sudden cardiac death in nonischemic dilated cardiomyopathy, with fragmented QRS and T-wave alternans showing the strongest associations.
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May refine arrhythmic risk stratification in nonischemic dilated cardiomyopathy; hypothesis-generating and requires prospective validation.
Goldberger et al. (2014) conducted a meta-analysis in nonischemic dilated cardiomyopathy (n=6,088). Risk stratification tests (e.g., fragmented QRS, T-wave alternans) was evaluated on arrhythmic events (OR 6.73, 95% CI 3.85-11.76). Fragmented QRS and T-wave alternans were the strongest predictors of arrhythmic events in nonischemic dilated cardiomyopathy (OR 6.73, 95% CI 3.85-11.76 and OR 4.66, 95% CI 2.55-8.53).
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