Document Detail


Electrocardiographic predictors of arrhythmic death and total mortality in the multicenter unsustained tachycardia trial.
MedLine Citation:
PMID:  15289365     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Stratifiers of sudden and total mortality risk are needed to optimally target preventive therapies in patients with coronary artery disease and impaired ventricular function. We assessed the prognostic significance of ECG markers of conduction abnormalities and left ventricular hypertrophy in the Multicenter Unsustained Tachycardia Trial (MUSTT). METHODS AND RESULTS: We analyzed the ECGs of 1638 patients from MUSTT who did not receive antiarrhythmic therapy (antiarrhythmic medication or implantable cardioverter-defibrillator). After adjustment for other significant factors, left bundle-branch block and intraventricular conduction delay were associated with a 50% increase in the risk of both arrhythmic and total mortality. Right bundle-branch block was not associated with arrhythmic or total mortality. Left ventricular hypertrophy was the only ECG predictor of arrhythmic (hazard ratio, 1.35; 95% CI, 1.08 to 1.69) but not total mortality. CONCLUSIONS: In patients with coronary artery disease, depressed left ventricular function, and nonsustained ventricular tachycardia, QRS prolongation resulting from left bundle-branch block or intraventricular conduction delay but not right bundle-branch block provided prognostic information about the risk of arrhythmic and total mortality independently of electrophysiological evaluation and ejection fraction. Left ventricular hypertrophy was associated with increased arrhythmic but not total mortality.
Authors:
Peter J Zimetbaum; Alfred E Buxton; William Batsford; John D Fisher; Gail E Hafley; Kerry L Lee; Michael F O'Toole; Richard L Page; Matthew Reynolds; Mark E Josephson
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial     Date:  2004-08-02
Journal Detail:
Title:  Circulation     Volume:  110     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-08-17     Completed Date:  2005-02-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  766-9     Citation Subset:  AIM; IM    
Affiliation:
Beth Israel Deaconess Medical Center, 185 Pilgrim Rd, Boston, Mass 02215, USA. pzimetba@BIDMC.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Arrhythmias, Cardiac / mortality*,  physiopathology
Bundle-Branch Block / epidemiology,  physiopathology
Cardiac Pacing, Artificial
Cause of Death
Electric Stimulation
Electrocardiography*
Female
Heart Arrest / epidemiology,  etiology
Heart Conduction System / physiopathology*
Humans
Hypertrophy, Left Ventricular / mortality,  physiopathology
Male
Middle Aged
Proportional Hazards Models
Risk
Single-Blind Method
Tachycardia / mortality,  physiopathology
United States / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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