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Risk score for the exclusion of arrhythmic events in arrhythmogenic right ventricular cardiomyopathy at first presentation.

Vischer, AS; Castelletti, S; Syrris, P; Bastiaenen, R; Miles, C; Akdis, D; Denhaerynck, K; Jacoby, D; Saguner, AM; Krahn, AD; et al. Vischer, AS; Castelletti, S; Syrris, P; Bastiaenen, R; Miles, C; Akdis, D; Denhaerynck, K; Jacoby, D; Saguner, AM; Krahn, AD; Behr, ER; McKenna, WJ; Pantazis, A (2019) Risk score for the exclusion of arrhythmic events in arrhythmogenic right ventricular cardiomyopathy at first presentation. Int J Cardiol, 290. pp. 100-105. ISSN 1874-1754 https://doi.org/10.1016/j.ijcard.2019.04.090
SGUL Authors: Bastiaenen, Rachel Marie Behr, Elijah Raphael Miles, Christopher Jason

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Abstract

AIMS: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a genetically determined heart muscle disorder associated with an increased risk of life-threatening arrhythmias in some patients. Risk stratification remains challenging. Therefore, we sought a non-invasive, easily applicable risk score to predict sustained ventricular arrhythmias in these patients. METHODS: Cohort of Patients who fulfilled the 2010 ARVC task force criteria were consecutively recruited. Detailed clinical data were collected at baseline and during follow up. The clinical endpoint was a composite of recurrent sustained ventricular arrhythmias and hospitalization due to ventricular arrhythmias. Multivariable logistic regression was used to develop models to predict the arrhythmic risk. A cohort including patients from other registries in UK, Canada and Switzerland was used as a validation population. RESULTS: One hundred and thirty-five patients were included of whom 35 patients (31.9%) reached the endpoint. A model consisting of filtered QRS duration on signal-averaged ECG, non-sustained VT (NSVT) on 24 h-ECG, and absence of negative T waves in lead aVR on 12‑lead surface ECG was able to predict arrhythmic events with a sensitivity of 81.8%, specificity of 84.0% and a negative predictive value of 95.5% at the first presentation of the disease. This risk score was validated in international ARVC registry patients. CONCLUSION: A risk score consisting of a filtered QRS duration ≥117 ms, presence of NSVT on 24 h-ECG and absence of negative T waves in lead aVR was able to predict arrhythmic events at first presentation of the disease.

Item Type: Article
Additional Information: © 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: Arrhythmic risk, Arrhythmogenic right ventricular cardiomyopathy, ICD, Risk stratification, Sudden cardiac death, Ventricular arrhythmia, Arrhythmogenic right ventricular cardiomyopathy, Arrhythmic risk, Ventricular arrhythmia, ICD, Sudden cardiac death, Risk stratification, Arrhythmic risk, Arrhythmogenic right ventricular cardiomyopathy, ICD, Risk stratification, Sudden cardiac death, Ventricular arrhythmia, 1102 Cardiovascular Medicine And Haematology, Cardiovascular System & Hematology
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Int J Cardiol
ISSN: 1874-1754
Language: eng
Dates:
DateEvent
1 September 2019Published
1 May 2019Published Online
29 April 2019Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
Projects:
Project IDFunderFunder ID
G-13-0002775Heart and Stroke Foundation of Canadahttp://dx.doi.org/10.13039/501100000222
MOP-142218Canadian Institutes of Health Researchhttp://dx.doi.org/10.13039/501100000024
SRG-15-P09-001Canadian Institutes of Health Researchhttp://dx.doi.org/10.13039/501100000024
RG/13/19/30568British Heart Foundationhttp://dx.doi.org/10.13039/501100000274
14 CVD 03Fondation Leducqhttp://dx.doi.org/10.13039/501100001674
PubMed ID: 31104822
Web of Science ID: WOS:000470826500020
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/110999
Publisher's version: https://doi.org/10.1016/j.ijcard.2019.04.090

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