Evidence map›Paper›PMID 30265438›Full record

ArticleAnnals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc2019

Combining noninvasive risk stratification parameters improves the prediction of mortality and appropriate ICD shocks.

Bert Vandenberk, M Juhani Junttila, Tomas Robyns, Christophe Garweg, Joris Ector, Heikki V Huikuri, Rik Willems

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.3field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 4 citations in OpenAlex.

  1. Review
  2. Review
  3. Repeating noninvasive risk stratification improves prediction of outcome in ICD patients.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2020
    Article
  4. 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 · 2019
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 2 countries.

Bert VandenberkDepartment of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.ORCID 0000-0001-8296-920X
M Juhani JunttilaResearch Unit of Internal Medicine, Medical Research Center, University Hospital and University of Oulu, Oulu, Finland.
Tomas RobynsDepartment of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
Christophe GarwegDepartment of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
Joris EctorDepartment of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
Heikki V HuikuriResearch Unit of Internal Medicine, Medical Research Center, University Hospital and University of Oulu, Oulu, Finland.
Rik WillemsDepartment of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
Universitair Ziekenhuis Leuven · BEOulu University Hospital · FI

Funding

European Community's Seventh Framework Program FP7: EU-CERT-ICD HEALTH-F2-2013-602299
6 · The paper itself

Abstract

backgroundSudden cardiac death (SCD) results from a complex interplay of abnormalities in autonomic function, myocardial substrate and vulnerability. We studied whether a combination of noninvasive risk stratification tests reflecting these key players could improve risk stratification.

methodsPatients implanted with an ICD in whom 24-hr holter recordings were available prior to implant were included. QRS fragmentation (fQRS) was selected as measure of myocardial substrate and a high ventricular premature beat count (VPB >10/hr) for arrhythmic vulnerability. From receiver operating characteristics analysis, detrended fluctuation analysis (DFA), turbulence slope, and deceleration capacity were selected for autonomic function. Adjusted Cox regression analysis with comparison of C-statistics was performed to predict first appropriate shock (AS) and total mortality.

resultsA total of 220 patients were included in the analysis with an overall follow-up of 4.3 ± 3.1 years. A model including VPB >10/hr, inferior fQRS, and abnormal nonedited DFA was the best for prediction of AS after 1 year of follow-up with a trends toward improvement of the C-statistics compared to baseline (p = 0.055). The risk increased significantly with every abnormal test (HR 1.793, 95%CI 1.255-2.564). A model including fQRS in any region and abnormal edited DFA was the best for prediction of mortality after 3 years of follow-up with significant improvement of the C-statistics (p = 0.023). Each abnormal test was associated with a significant increase in mortality (HR 5.069, 95%CI 1.978-12.994).

conclusionCombining noninvasive risk stratification tests according to their physiological background can improve the risk prediction of SCD and mortality.

Indexed as

Defibrillators, ImplantableBelgiumCohort StudiesDeath, Sudden, CardiacElectrocardiographyElectrocardiography, AmbulatoryFemaleFollow-Up StudiesHeart FailureHospital MortalityHospitals, UniversityHumansMalePredictive Value of TestsProportional Hazards ModelsRegistriesheart rate variabilityimplantable cardioverter-defibrillatorsudden cardiac death

Identifiers

PMID30265438
PMCPMC6931642
OpenAlexW2893316879

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

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.