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December 9, 2020Circulation Arrhythmia and ElectrophysiologyOpen Access

Sudden Cardiac Death Prediction in Arrhythmogenic Right Ventricular Cardiomyopathy

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Key result

A 4-variable clinical prediction model predicted life-threatening ventricular arrhythmias in patients with ARVC with an optimism-corrected C-index of 0.74 (95% CI, 0.69-0.80).

Why the study?

Existing models predicting sustained ventricular arrhythmias in ARVC may overestimate sudden cardiac death risk, warranting a model specifically predicting life-threatening ventricular arrhythmias.

Can a clinical prediction model accurately predict life-threatening ventricular arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy?

Population

864 patients with definite ARVC from 15 centers in North America and Europe

Comparison

8 prespecified clinical predictors of life-threatening ventricular arrhythmias

Design

Multicenter retrospective cohort study

Follow-up

5.75 years (interquartile range, 2.77–10.58)

Authors

JCJulia Cadrin‐TourignyLBLaurens P. BosmanWWWeijia Wang

Discussion

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Member takes

Overview

May aid LTVA risk stratification in ARVC with 4 predictors; leaves open external validation before guiding practice.

Study Design

Type

Cohort (n=864)

Multicenter

Yes

Structured PICO

Can a clinical prediction model accurately predict life-threatening ventricular arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy?

P
Population
864 patients with definite ARVC (mean age 40 years, 53% male) followed for a median of 5.75 years to predict life-threatening ventricular arrhythmias.
E
Exposure
A novel prediction model using 4 clinical predictors (younger age, male sex, premature ventricular complex count, and number of leads with T-wave inversion)
O
Outcome
Life-threatening ventricular arrhythmias (LTVA), defined as sudden cardiac death (SCD), aborted SCD, sustained, or implantable cardioverter-defibrillator treated ventricular tachycardia >250 beats per minutecomposite

Main Result

Effect estimate: C-index 0.74 (95% CI 0.69-0.80)

A simple 4-variable clinical model can predict life-threatening ventricular arrhythmias in patients with ARVC, while prior sustained VA and extent of functional heart disease were not predictive.

Cite This Study

Cadrin‐Tourigny et al. (2020) conducted a cohort in Arrhythmogenic right ventricular cardiomyopathy (ARVC) (n=864). 4-variable clinical prediction model (younger age, male sex, premature ventricular complex count, and number of leads with T-wave inversion) was evaluated on Life-threatening ventricular arrhythmias (LTVA) (C-index 0.74, 95% CI 0.69-0.80). A 4-variable clinical prediction model predicted life-threatening ventricular arrhythmias in patients with ARVC with an optimism-corrected C-index of 0.74 (95% CI, 0.69-0.80).

synapsesocial.com/papers/6a7348edd98d9ee37dc8fb9dhttps://doi.org/10.1161/circep.120.008509
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Retracted and Republished: A new prediction model for ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy2019 · 266 citations
  2. 2Prediction of ventricular arrhythmia and sudden death in arrhythmogenic right ventricular cardiomyopathy2019 · 23 citations
  3. 3Spectrum of Clinicopathologic Manifestations of Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia: A Multicenter Study1997 · 984 citations
  4. 4Implantable Cardioverter‐Defibrillator Therapy in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy: Predictors of Appropriate Therapy, Outcomes, and Complications2017 · 92 citations
  5. 5Combination of ECG and Echocardiography for Identification of Arrhythmic Events in Early ARVC2016 · 98 citations