Use of spectral turbulence analysis for the identification of patients at high risk for ventricular fibrillation and sudden death in patients with hypertrophic cardiomyopathy.
Hypertrophic cardiomyopathy carries an increased risk of sudden death. The aim of the present study was to assess the predictive value of the signal-averaged ECG, analysed in the time domain and using a new method, spectral turbulence analysis, for the identification of high-risk patients. Two-hundred and forty-six patients with hypertrophic cardiomyopathy were studied. During a mean follow-up of 68 +/- 17 months, 17 patients died suddenly. Patients with sudden death (SD) and/or a history of ventricular fibrillation (VF; n = 25) were compared to patients without SD/VF (n = 221) and to patients without any recognised risk factors for SD (n = 82). There were no differences in mean values of the time domain or spectral turbulence parameters analysed between patients in the SD/VF group and the patients without SD/VF or in the low-risk group. It is concluded that the clinical usefulness of the signal-averaged ECG, analysed in the time domain or as spectral turbulence analysis, is limited in identifying high-risk patients with hypertrophic cardiomyopathy.
St. George's Hospital Medical School, Department of Cardiological Sciences, London, UK.
A
A
Englund
K
K
Hnatkova
P
P
Kulakowski
P M
PM
Elliot
M
M
Malik
W J
WJ
McKenna
D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications* / Q000401:mortality / Q000503:physiopathology; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted; D015996:Survival Rate; D014693:Ventricular Fibrillation / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology