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Electrocardiographic left ventricular hypertrophy predicts arrhythmia and mortality in patients with ischemic cardiomyopathy.

Publication ,  Journal Article
Bender, SR; Friedman, DJ; Markowitz, SM; Lerman, BB; Okin, PM
Published in: J Interv Card Electrophysiol
September 2012

PURPOSE: The relatively low incidence of device-treated ventricular arrhythmias in patients with ischemic cardiomyopathy (ICM) who receive implantable cardioverter defibrillators (ICDs) for primary prevention makes improved risk stratification of ICM patients a priority. Although Cornell product (CP) ECG left ventricular hypertrophy (LVH) has been associated with increased mortality in hypertensive patients and population-based studies, whether CP LVH can improve risk stratification of high-risk ICM patients is unclear. The aim of this study is to examine if electrocardiographic LVH predicts mortality and incident ventricular arrhythmia in patients with ICM. METHODS: All-cause mortality was examined in 317 patients with ICM and a history of non-sustained ventricular tachycardia (VT) who underwent electrophysiology testing. Incident VT and ventricular fibrillation (VF) were assessed in ICD recipients (n = 186). ECG LVH was defined by CP criteria: [(R (aVL) + S (V3)) + 6 mm in women] × QRS duration >2,440 mm ms. RESULTS: During 3 years of follow-up, mortality was 20% (64 of 317) and death or incident VT or VF occurred in 35% of ICD recipients. CP LVH was associated with significantly greater 3-year mortality (28% vs 15%, p = 0.015) and 3-year mortality or incident VT/VF in ICD patients (48% vs 35%, p = 0.011). In Cox multivariate models, CP LVH was an independent predictor of mortality in all patients (hazard ratio (HR) 1.81, 95% confidence interval (CI) 1.11-2.97, p = 0.020) and of the composite endpoint of mortality or incident ventricular arrhythmia in ICD patients (HR 1.82, 95% CI 1.12-3.00, p = 0.016). CONCLUSIONS: ECG LVH using CP criteria may enhance risk stratification in high-risk patients with ICM.

Duke Scholars

Published In

J Interv Card Electrophysiol

DOI

EISSN

1572-8595

Publication Date

September 2012

Volume

34

Issue

3

Start / End Page

237 / 245

Location

Netherlands

Related Subject Headings

  • Ventricular Fibrillation
  • Tachycardia, Ventricular
  • Risk Factors
  • Risk Assessment
  • Prospective Studies
  • Proportional Hazards Models
  • Primary Prevention
  • Predictive Value of Tests
  • Myocardial Ischemia
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Bender, S. R., Friedman, D. J., Markowitz, S. M., Lerman, B. B., & Okin, P. M. (2012). Electrocardiographic left ventricular hypertrophy predicts arrhythmia and mortality in patients with ischemic cardiomyopathy. J Interv Card Electrophysiol, 34(3), 237–245. https://doi.org/10.1007/s10840-011-9661-2
Bender, Seth R., Daniel J. Friedman, Steven M. Markowitz, Bruce B. Lerman, and Peter M. Okin. “Electrocardiographic left ventricular hypertrophy predicts arrhythmia and mortality in patients with ischemic cardiomyopathy.J Interv Card Electrophysiol 34, no. 3 (September 2012): 237–45. https://doi.org/10.1007/s10840-011-9661-2.
Bender SR, Friedman DJ, Markowitz SM, Lerman BB, Okin PM. Electrocardiographic left ventricular hypertrophy predicts arrhythmia and mortality in patients with ischemic cardiomyopathy. J Interv Card Electrophysiol. 2012 Sep;34(3):237–45.
Bender, Seth R., et al. “Electrocardiographic left ventricular hypertrophy predicts arrhythmia and mortality in patients with ischemic cardiomyopathy.J Interv Card Electrophysiol, vol. 34, no. 3, Sept. 2012, pp. 237–45. Pubmed, doi:10.1007/s10840-011-9661-2.
Bender SR, Friedman DJ, Markowitz SM, Lerman BB, Okin PM. Electrocardiographic left ventricular hypertrophy predicts arrhythmia and mortality in patients with ischemic cardiomyopathy. J Interv Card Electrophysiol. 2012 Sep;34(3):237–245.
Journal cover image

Published In

J Interv Card Electrophysiol

DOI

EISSN

1572-8595

Publication Date

September 2012

Volume

34

Issue

3

Start / End Page

237 / 245

Location

Netherlands

Related Subject Headings

  • Ventricular Fibrillation
  • Tachycardia, Ventricular
  • Risk Factors
  • Risk Assessment
  • Prospective Studies
  • Proportional Hazards Models
  • Primary Prevention
  • Predictive Value of Tests
  • Myocardial Ischemia
  • Male