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.

Results

  • 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).

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