Electrocardiographic left ventricular hypertrophy predicts arrhythmia and mortality in patients with ischemic cardiomyopathy
Journal of Interventional Cardiac Electrophysiology , 02/28/2012
Bender SR et al. – ECG left ventricular hypertrophy using Cornell product criteria may enhance risk stratification in high–risk patients with ischemic cardiomyopathy.Methods
- All-cause mortality was examined in 317 patients with ICM and a history of non-sustained ventricular tachycardia (VT) who underwent electrophysiology testing.
- Incident VT and ventricular fibrillation (VF) were assessed in ICD recipients (n=186).
- ECG LVH was defined by CP criteria: [(R aVL+S V3)+6 mm in women]×QRS duration >2,440 mm ms.
- During 3 years of follow-up, mortality was 20% (64 of 317) and death or incident VT or VF occurred in 35% of ICD recipients.
- CP LVH was associated with significantly greater 3-year mortality (28% vs 15%, p=0.015) and 3-year mortality or incident VT/VF in ICD patients (48% vs 35%, p=0.011).
- In Cox multivariate models, CP LVH was an independent predictor of mortality in all patients (hazard ratio (HR) 1.81, 95% confidence interval (CI) 1.11–2.97, p=0.020) and of the composite endpoint of mortality or incident ventricular arrhythmia in ICD patients (HR 1.82, 95% CI 1.12–3.00, p=0.016).