Prediction of arrhythmic events by Wedensky modulation in patients with coronary artery disease
PRINCIPLES: Prediction of arrhythmic events (AEs) has gained importance with the availability of implantable cardioverter-defibrillators (ICDs), but is still imprecise. This study evaluated the innovative Wedensky modulation index (WMI) as predictor of AEs. METHODS: In this prospective...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2014-02-01
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| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/1825 |
| _version_ | 1811194166630154240 |
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| author | Andreas W Schoenenberger Olivia Schär Richard Kobza Paul Erne |
| author_facet | Andreas W Schoenenberger Olivia Schär Richard Kobza Paul Erne |
| author_sort | Andreas W Schoenenberger |
| collection | DOAJ |
| description |
PRINCIPLES: Prediction of arrhythmic events (AEs) has gained importance with the availability of implantable cardioverter-defibrillators (ICDs), but is still imprecise. This study evaluated the innovative Wedensky modulation index (WMI) as predictor of AEs.
METHODS: In this prospective cohort, 179 patients with coronary artery disease (CAD) referred for AE risk assessment underwent baseline evaluation including measurement of R-/T-wave WMI (WMIRT) and left ventricular ejection fraction (LVEF). Two endpoints were assessed 3 years after the baseline evaluation: sudden cardiac death or appropriate ICD event (EP1) and any cardiac death or appropriate ICD event (EP2). Associations between baseline predictors (WMIRT and LVEF) and endpoints were evaluated in regression models.
RESULTS: Only three patients were lost to follow-up. EP1 and EP2 occurred in 24 and 27 patients, respectively. WMIRT (odds ratio [OR] per 1 point increase for EP1 20.1, 95% confidence interval [CI] 1.8–221.4, p = 0.014, and for EP2 73.3, 95% CI 6.6–817.7, p <0.001) and LVEF (OR per 1% increase for EP1 0.94, 95% CI 0.90–0.99, p = 0.013, and for EP2 0.93, 95% CI 0.89–0.97, p = 0.002) were significantly associated with both endpoints. In bivariable regression controlled for LVEF, WMIRT was independently associated with EP1 (p = 0.047) and EP2 (p = 0.007). The combination of WMIRT ≥0.60 and LVEF ≤30% resulted in a positive predictive value of 36% for EP1 and 50% for EP2.
CONCLUSIONS: WMIRT is a significant predictor of AEs independent of LVEF and has potential to improve AE risk prediction in CAD patients. However, WMIRT should be evaluated in larger and independent samples before recommendations for clinical routine can be made.
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| first_indexed | 2024-04-12T00:21:23Z |
| format | Article |
| id | doaj.art-95af043728884672a3b80dab37eb8111 |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2024-04-12T00:21:23Z |
| publishDate | 2014-02-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-95af043728884672a3b80dab37eb81112022-12-22T03:55:43ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972014-02-01144070810.4414/smw.2014.13929Prediction of arrhythmic events by Wedensky modulation in patients with coronary artery diseaseAndreas W SchoenenbergerOlivia SchärRichard KobzaPaul Erne PRINCIPLES: Prediction of arrhythmic events (AEs) has gained importance with the availability of implantable cardioverter-defibrillators (ICDs), but is still imprecise. This study evaluated the innovative Wedensky modulation index (WMI) as predictor of AEs. METHODS: In this prospective cohort, 179 patients with coronary artery disease (CAD) referred for AE risk assessment underwent baseline evaluation including measurement of R-/T-wave WMI (WMIRT) and left ventricular ejection fraction (LVEF). Two endpoints were assessed 3 years after the baseline evaluation: sudden cardiac death or appropriate ICD event (EP1) and any cardiac death or appropriate ICD event (EP2). Associations between baseline predictors (WMIRT and LVEF) and endpoints were evaluated in regression models. RESULTS: Only three patients were lost to follow-up. EP1 and EP2 occurred in 24 and 27 patients, respectively. WMIRT (odds ratio [OR] per 1 point increase for EP1 20.1, 95% confidence interval [CI] 1.8–221.4, p = 0.014, and for EP2 73.3, 95% CI 6.6–817.7, p <0.001) and LVEF (OR per 1% increase for EP1 0.94, 95% CI 0.90–0.99, p = 0.013, and for EP2 0.93, 95% CI 0.89–0.97, p = 0.002) were significantly associated with both endpoints. In bivariable regression controlled for LVEF, WMIRT was independently associated with EP1 (p = 0.047) and EP2 (p = 0.007). The combination of WMIRT ≥0.60 and LVEF ≤30% resulted in a positive predictive value of 36% for EP1 and 50% for EP2. CONCLUSIONS: WMIRT is a significant predictor of AEs independent of LVEF and has potential to improve AE risk prediction in CAD patients. However, WMIRT should be evaluated in larger and independent samples before recommendations for clinical routine can be made. https://www.smw.ch/index.php/smw/article/view/1825wedensky inhibition. |
| spellingShingle | Andreas W Schoenenberger Olivia Schär Richard Kobza Paul Erne Prediction of arrhythmic events by Wedensky modulation in patients with coronary artery disease Swiss Medical Weekly wedensky inhibition. |
| title | Prediction of arrhythmic events by Wedensky modulation in patients with coronary artery disease |
| title_full | Prediction of arrhythmic events by Wedensky modulation in patients with coronary artery disease |
| title_fullStr | Prediction of arrhythmic events by Wedensky modulation in patients with coronary artery disease |
| title_full_unstemmed | Prediction of arrhythmic events by Wedensky modulation in patients with coronary artery disease |
| title_short | Prediction of arrhythmic events by Wedensky modulation in patients with coronary artery disease |
| title_sort | prediction of arrhythmic events by wedensky modulation in patients with coronary artery disease |
| topic | wedensky inhibition. |
| url | https://www.smw.ch/index.php/smw/article/view/1825 |
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