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Prediction of arrhythmic events after myocardial infarction based on signal-averaged electrocardiogram and ejection fraction

Schoenenberger, A. W. and Erne, P. and Ammann, S. and Gillmann, G. and Kobza, R. and Stuck, A. E.. (2008) Prediction of arrhythmic events after myocardial infarction based on signal-averaged electrocardiogram and ejection fraction. Pacing and clinical electrophysiology, Vol. 31, H. 2. pp. 221-228.

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Official URL: http://edoc.unibas.ch/dok/A6004349

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Abstract

BACKGROUND: Trials on implantable cardioverter-defibrillators (ICD) for patients after acute myocardial infarction (AMI) have highlighted the need for risk assessment of arrhythmic events (AE). The aim of this study was to evaluate risk predictors based on a novel approach of interpreting signal-averaged electrocardiogram (SAECG) and ejection fraction (EF). METHODS: SAECG, interpreted with a new index, and EF were prospectively evaluated to predict AE in 144 patients with AMI. RESULTS: During the mean follow-up period of 4.1 years, 19 AE occurred. The new SAECG index showed a sensitivity of 84%, a specificity of 62%, a positive predictive value (PPV) of 25%, and a negative predictive value (NPV) of 96%. A combination of a normal new SAECG index and an EF <35% resulted in a sensitivity of 100%, a specificity of 47%, a PPV of 22%, and a NPV of 100%; this corresponded to an AE incidence rate of 0%. When both tests were abnormal, the AE incidence rate was 21.3%. CONCLUSIONS: This is the first contemporary study reporting predictive values based on a combination of SAECG and EF. If confirmed in an appropriately designed and powered trial, this novel approach might be used to identify both patients at very low risk for AE not requiring further risk assessment and patients at high risk in whom ICD implantation can be considered without further risk assessment.
Faculties and Departments:03 Faculty of Medicine > Departement Biomedizin > Further Research Groups at DBM > Signal Transduction (Resink/Erne)
UniBasel Contributors:Erne, Paul
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Blackwell Futura Publishing
ISSN:0147-8389
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:25 Apr 2014 08:00
Deposited On:25 Apr 2014 08:00

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