Document Detail

Prediction of arrhythmic events after myocardial infarction based on signal-averaged electrocardiogram and ejection fraction.
MedLine Citation:
PMID:  18233976     Owner:  NLM     Status:  MEDLINE    
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.
Andreas W Schoenenberger; Paul Erne; Stephan Ammann; Gerhard Gillmann; Richard Kobza; Andreas E Stuck
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  31     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-31     Completed Date:  2008-05-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  221-8     Citation Subset:  IM    
Department of General Internal Medicine, Inselspital University of Bern Hospital, Bern, Switzerland.
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MeSH Terms
Aged, 80 and over
Arrhythmias, Cardiac / diagnosis*,  etiology,  physiopathology
Middle Aged
Myocardial Infarction / complications*
Predictive Value of Tests
Proportional Hazards Models
Prospective Studies
Risk Factors
Sensitivity and Specificity
Stroke Volume

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

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