Document Detail

Non-sustained ventricular tachycardia as a predictor of sudden cardiac death in patients with left ventricular dysfunction: a meta-analysis.
MedLine Citation:
PMID:  18692437     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Identifying patients at risk of sudden cardiac death (SCD) remains a challenge.
AIM: To evaluate the performance of non-sustained ventricular tachycardia (NSVT) from 24 hour ambulatory electrocardiography as a predictor of SCD in patients with heart failure or non-ischaemic dilated cardiomyopathy with left ventricular systolic dysfunction (LVSD).
METHODS AND RESULTS: Study search and selection were performed by independent reviewers using a validated strategy. Eleven prognostic studies with >100 patients with good quality data and multivariate analysis of predictors of SCD were included. Publication bias was evaluated by funnel plot with Kendall's tau b test. A summary ROC (sROC) curve was built to evaluate predictive performance of NSVT. There was threshold effect (Spearman's correlation between sensitivity and specificity=-0.818, p<0.01) which indicates that combining sensitivity and specificity was not appropriate. The area of 0.68+/-0.02 under the sROC curve indicates a statistically significant contribution of NSVT in the prediction of SCD. The true negative rate varied from 89 to 97%. Multivariate analysis and meta-regression suggested that the contribution of NSVT to risk stratification is independent of ejection fraction.
CONCLUSIONS: Absence of NSVT indicated a low probability of SCD in patients with LVSD. A risk score including NSVT should be evaluated in prospective studies.
Marcos R de Sousa; Carlos A Morillo; Fábio T Rabelo; Antônio M Nogueira Filho; Antonio L P Ribeiro
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Publication Detail:
Type:  Journal Article; Meta-Analysis     Date:  2008-08-09
Journal Detail:
Title:  European journal of heart failure     Volume:  10     ISSN:  1388-9842     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-20     Completed Date:  2009-02-11     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1007-14     Citation Subset:  IM    
Post-Graduate Program in Internal Medicine, Universidade Federal de Minas Gerais, Brazil.
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MeSH Terms
Cardiomyopathy, Dilated / physiopathology
Death, Sudden, Cardiac / etiology*,  pathology
Heart Failure / physiopathology
Multivariate Analysis
Predictive Value of Tests
ROC Curve
Risk Factors
Sensitivity and Specificity
Tachycardia, Ventricular / complications*,  physiopathology
Time Factors
Ventricular Dysfunction, Left / complications*,  physiopathology

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