Prognostic value of ambulatory electrocardiography monitoring in patients with dilated cardiomyopathy.
BACKGROUND
Performance of ambulatory electrocardiography (AECG) may provide data useful for counseling patients regarding prognosis and for selecting potential patients for defibrillator implantation, but this practice remains controversial.


METHODS
We reviewed clinical and AECG data on 355 patients diagnosed with dilated cardiomyopathy (DCM). Predictors of survival were identified in a multivariable analysis using a Cox proportional hazard model. Ability of the derived model to predict outcomes was tested using a second cohort of 144 patients.


RESULTS
Nonsustained ventricular tachycardia (NSVT) was present on AECG in 31% of the subjects. Ambulatory electrocardiography provided 3 independent predictors of mortality: NSVT (relative risk [RR], 1.63; 95% confidence interval [CI], 1.06-2.51; P = .02), mean heart rate (RR, 1.03; 95% CI, 1.02-1.04; P = .0001), and heart rate range (RR, 0.990; 95% CI, 0.982-0.997; P = .008). Performance of the multivariable model was validated (area under the curve = 0.83) on a second cohort of patients.


CONCLUSIONS
Ambulatory electrocardiography provides useful prognostic information in patients with DCM, identifying 3 independent predictors of mortality.
Baker
Robert L
RL
Division of Cardiology, University of Michigan Medical Center, Ann Arbor, MI 48109, USA.
Koelling
Todd M
TM
D000367:Age Factors; D019540:Area Under Curve; D002303:Cardiac Output, Low / Q000503:physiopathology; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology* / Q000628:therapy; D002423:Cause of Death; D015331:Cohort Studies; D017147:Defibrillators, Implantable; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D013318:Stroke Volume / Q000502:physiology; D015996:Survival Rate; D017180:Tachycardia, Ventricular / Q000503:physiopathology; D018879:Ventricular Premature Complexes / Q000503:physiopathology