ArticlePacing and clinical electrophysiology : PACE2015
VV' Alternans Triplets on Near-Field ICD Intracardiac Electrogram is Associated with Mortality.
Article in Pacing and clinical electrophysiology : PACE, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00916435 (Prospective Observational Study of the ICD Intracardiac Electrograms for Prediction of Ventricular Tachyarrhythmias and Congestive Heart Failure), which is not on this map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prospective Observational Study of the ICD Intracardiac Electrograms for Prediction of Ventricular Tachyarrhythmias and Congestive Heart Failure
Who cites it
2 citing papers in PubMed, 3 citations in OpenAlex.
- Reproducibility of Heart Rate Variability Characteristics Measured on Random 10-second ECG using Joint Symbolic Dynamics.Computing in cardiology · 2016Article
- High atrioventricular phase index on near-field intracardiac electrogram is associated with risk of ventricular arrhythmia.Journal of electrocardiologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundIn heart failure patients with implantable cardioverter defibrillator (ICD) the risk of death from causes other than tachyarrhythmia is substantial. Benefit from ICD is determined by two competing risks: appropriate ICD shock or nonarrhythmic death. The goal of the study was to test predictors of competing outcomes.
methodsPatients with structural heart disease (N = 234, mean age 58.5 ± 15.1; 71% men, 80% whites, 61% ischemic cardiomyopathy) and primary (75%) or secondary prevention ICD underwent a 5-minute baseline near-field electrogram (NF EGM) recording. VV' alternans triplets were quantified as a percentage of three sinus VV' cycles sequences of "short-long-short" or "long-short-long" order. Appropriate ICD shock for fast ventricular tachycardia (FVT, cycle length ≤240 ms)/ventricular fibrillation (VF) and composite nonarrhythmic death (pump failure death or heart transplant) served as competing outcomes.
resultsOver a median follow-up of 2.4 years, 26 patients (4.6% per person-year of follow-up) developed FVT/VF with ICD shock, and 35 (6.3% per person-year of follow-up) had nonarrhythmic death. In competing risk analysis, after adjustment for demographics, left ventricular ejection fraction, New York Heart Association class, cardiomyopathy type, use of class I antiarrhythmics, and diabetes, increased percentage of VV' alternans triplets (>69%) was associated with nonarrhythmic death (subhazard ratio [SHR] 2.09; 95% confidence interval [CI] 1.03-4.23; P = 0.041), rather than with FVT/VF (SHR 1.05; 95% CI 0.45-2.46; P = 0.901). Risk of nonarrhythmic death was especially high in diabetics with VV' alternans triplets in the highest quartile (SHR 3.46; 95% CI 1.41-8.50; P = 0.007).
conclusionIn ICD patients with structural heart disease sinus VV' alternans triplets on NF EGM is independently associated with nonarrhythmic death, rather than with FVT/VF.
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