ArticleHeart (British Cardiac Society)2024
QRS complex and T wave planarity for the efficacy prediction of automatic implantable defibrillators.
Article in Heart (British Cardiac Society), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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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.
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Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- Beat-to-Beat QT Variability: A Population Study of the QT Variability Index Composition.Diagnostics (Basel, Switzerland) · 2026Article
- Direct evaluation of the electrocardiographic spatial QRS-T angle without the need for orthogonal transformation.Scientific reports · 2026Article
- Intra-subject covariates of QT variability indices: influence of ECG noise.Frontiers in physiology · 2026Article
- Novel three-dimensional ECG algorithm for reliable screening for cardiac amyloidosis.ESC heart failure · 2025Article
- Ventricular Depolarization Abnormalities and Their Role in Cardiac Risk Stratification - A Narrative Review.Reviews in cardiovascular medicine · 2025Review
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Authors and funding
17 authors at 10 institutions in 8 countries.
Funding
Abstract
objectiveTo test the hypothesis that in recipients of primary prophylactic implantable cardioverter-defibrillators (ICDs), the non-planarity of ECG vector loops predicts (a) deaths despite ICD protection and (b) appropriate ICD shocks.
methodsDigital pre-implant ECGs were collected in 1948 ICD recipients: 21.4% females, median age 65 years, 61.5% ischaemic heart disease (IHD). QRS and T wave three-dimensional loops were constructed using singular value decomposition that allowed to measure the vector loop planarity. The non-planarity, that is, the twist of the three-dimensional loops out of a single plane, was related to all-cause mortality (n=294; 15.3% females; 68.7% IHD) and appropriate ICD shocks (n=162; 10.5% females; 87.7% IHD) during 5-year follow-up after device implantation. Using multivariable Cox regression, the predictive power of QRS and T wave non-planarity was compared with that of age, heart rate, left ventricular ejection fraction, QRS duration, spatial QRS-T angle, QTc interval and T-peak to T-end interval.
resultsQRS non-planarity was significantly (p<0.001) associated with follow-up deaths despite ICD protection with HR of 1.339 (95% CI 1.165 to 1.540) but was only univariably associated with appropriate ICD shocks. Non-planarity of the T wave loop was the only ECG-derived index significantly (p<0.001) associated with appropriate ICD shocks with multivariable Cox regression HR of 1.364 (1.180 to 1.576) but was not associated with follow-up mortality.
conclusionsThe analysed data suggest that QRS and T wave non-planarity might offer distinction between patients who are at greater risk of death despite ICD protection and those who are likely to use the defibrillator protection.
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