title: The utilization of twelve-lead electrocardiography for predicting sudden cardiac death after heart transplantation.
abstract: BACKGROUND
  Sudden cardiac death (SCD) occurs commonly after heart transplantation (HTX). The utilization of surface electrocardiography (ECG) to assess post-HTX SCD has not been investigated thoroughly. This study aimed to investigate the specific changes in surface ECG in HTX patients with SCD.
  
  
  METHODS
  A total of 227 HTX patients (age 48 ± 14 y/o, mean donor age 34 ± 14 y/o, 173 males) were followed up regularly at the outpatient clinic. Twelve-lead ECG's were recorded during 1-2 monthly visits. Serial ECG parameters and relevant clinical data were collected and analyzed.
  
  
  RESULTS
  During the follow-up period of 96 ± 51 months, SCD occurred in 28 (12.3%) patients. The baseline ECG parameters were comparable between patients with and without SCD. Important ECG trends of rising rest heart rates and prolongation of corrected QT (QTc) and JT (JTc) intervals were observed prior to development of SCD. After adjustment for other clinical variables, the independent predictors for SCD were older donor age (p = 0.014, OR 1.05, 95% CI 1.01-1.09), faster heart rate (p = 0.006, OR 1.06, 95% CI 1.02-1.1) and longer JTc interval (p = 0.015, OR 1.03, 95% CI 1.01-1.06). SCD occurred in 71.4% patients presenting with all three risk predictors.
  
  
  CONCLUSIONS
  Besides older donor age, important ECG signs, including prolongation of the JTc interval and increased heart rate during post HTX follow up, could predict SCD.
authors.affiliation: Division of Cardiology, Cheng Hsin General Hospital, Taipei, Taiwan; Institute of Clinical Medicine and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Hung-Yu
authors.initials: HY
authors.lastname: Chang
authors.forename: Wei-Hsian
authors.initials: WH
authors.lastname: Yin
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Lo
authors.forename: Yenn-Jiang
authors.initials: YJ
authors.lastname: Lin
authors.forename: Shih-Lin
authors.initials: SL
authors.lastname: Chang
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Hu
authors.forename: An-Ning
authors.initials: AN
authors.lastname: Feng
authors.forename: Meng-Cheng
authors.initials: MC
authors.lastname: Chiang
authors.forename: Mason-Shing
authors.initials: MS
authors.lastname: Young
authors.forename: Chong-Yi
authors.initials: CY
authors.lastname: Chang
authors.forename: Yi-Cheng
authors.initials: YC
authors.lastname: Chuang
authors.forename: Eric
authors.initials: E
authors.lastname: Chong
authors.forename: Shih-Ann
authors.initials: SA
authors.lastname: Chen
authors.forename: Jeng
authors.initials: J
authors.lastname: Wei
mesh_terms: D000328:Adult; D016757:Death, Sudden, Cardiac; D004562:Electrocardiography / Q000295:instrumentation*; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012189:Retrospective Studies
keywords: CAV; ECG; Electrocardiography; HTX; Heart rate; Heart transplantation; LBBB; LV; LVEF; RBBB; SCD; Sudden death; cardiac allograft vasculopathy; electrocardiography; heart transplantation; left bundle branch block; left ventricular; left ventricular ejection fraction; right bundle branch block; sudden cardiac death