Trial reportHeart rhythm2015
SCD-HeFT: Use of R-R interval statistics for long-term risk stratification for arrhythmic sudden cardiac death.
Trial report in Heart rhythm, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 15 papers, 1 of them a synthesis that pooled it.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Heart Rate Variability and Heart Failure with Reduced Ejection Fraction: A Systematic Review of Literature.Current cardiology reviews · 2025Pooled it
- Fractal dimension of the aortic annulus: a novel predictor of paravalvular leak after transcatheter aortic valve implantation.The international journal of cardiovascular imaging · 2022Trial
- Usefulness of measurement of heart rate variability by holter ECG in hemodialysis patients.BMC nephrology · 2017Trial
- Association of non-linear dynamics of heart rate variability with all-cause mortality in patients with sarcoidosis.Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG · 2025Article
- Assessment of the long RR intervals using convolutional neural networks in single-lead long-term Holter electrocardiogram recordings.Scientific reports · 2025Article
- Repeated heart rate variability monitoring after myocardial infraction - Cohort profile of the MI-ECG study.International journal of cardiology. Heart & vasculature · 2025Article
- Performance of heart rate adjusted heart rate variability for risk stratification of sudden cardiac death.BMC cardiovascular disorders · 2023Article
- Emerging role of artificial intelligence in cardiac electrophysiology.Cardiovascular digital health journal · 2022Review
- Characteristics of the Dynamic Electrocardiogram in the Elderly with Nonvalvular Atrial Fibrillation Combined with Long R-R Intervals.Evidence-based complementary and alternative medicine : eCAM · 2021Article
- Prediction of Sudden Cardiac Death Risk with a Support Vector Machine Based on Heart Rate Variability and Heartprint Indices.Sensors (Basel, Switzerland) · 2020Article
- Combining noninvasive risk stratification parameters improves the prediction of mortality and appropriate ICD shocks.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2019Article
- An inappropriate pacing threshold increase after repeated electrical storm in a patient with implantable cardioverter defibrillator.BMC cardiovascular disorders · 2017Article
- The fractal heart - embracing mathematics in the cardiology clinic.Nature reviews. Cardiology · 2017Review
- Effect of salt intake on beat-to-beat blood pressure nonlinear dynamics and entropy in salt-sensitive versus salt-protected rats.Physiological reports · 2016Article
- Predicting the risk of sudden cardiac death.The Journal of physiology · 2016Review
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
10 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundIn the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), a significant fraction of the patients with congestive heart failure ultimately did not die suddenly of arrhythmic causes. Patients with CHF will benefit from better tools to identify if implantable cardioverter-defibrillator (ICD) therapy is needed.
objectivesWe aimed to identify predictor variables from baseline SCD-HeFT patients' R-R intervals that correlate to arrhythmic sudden cardiac death (SCD) and mortality and to design an ICD therapy screening test.
methodsTen predictor variables were extracted from prerandomization Holter data from 475 patients enrolled in the ICD arm of the SCD-HeFT by using novel and traditional heart rate variability methods. All variables were correlated to SCD using the Mann-Whitney-Wilcoxon test and receiver operating characteristic analysis. ICD therapy screening tests were designed by minimizing the cost of false classifications. Survival analysis, including log-rank test and Cox models, was also performed.
resultsA short-term fractal exponent, α1, and a long-term fractal exponent, α2, from detrended fluctuation analysis, the ratio of low- to high-frequency power, the number of premature ventricular contractions per hour, and the heart rate turbulence slope are all statistically significant for predicting the occurrences of SCD (P < .001) and survival (log-rank, P < .01). The most powerful multivariate predictor tool using the Cox proportional hazards regression model was α2 with a hazard ratio of 0.0465 (95% confidence interval 0.00528-0.409; P < .01).
conclusionPredictor variables extracted from R-R intervals correlate to the occurrences of SCD and distinguish survival functions among patients with ICDs in SCD-HeFT. We believe that SCD prediction models should incorporate Holter-based R-R interval analysis to refine ICD patient selection, especially to exclude patients who are unlikely to benefit from ICD therapy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.