title: Electrocardiographic predictors of sudden and non-sudden cardiac death in patients with ischemic cardiomyopathy.
abstract: OBJECTIVE
  This study evaluated the prognostic value of electrocardiogram (ECG)-based predictors in the primary prevention of sudden cardiac arrest (SCA) among ischemic cardiomyopathy patients with depressed left ventricular ejection fraction (LVEF ≤35%).
  
  
  BACKGROUND
  The prediction of cause-specific mortality in high-risk patients offers the potential for targeting specific therapies (i.e., implantable cardioverter-defibrillator [ICD]).
  
  
  METHODS
  Subjects were recruited from the Prediction of Arrhythmic Events with Positron Emission Tomography (PAREPET) study. Continuous Holter 12-lead ECG recordings were obtained at the start of study and used to compute 15 clinically-important ECG abnormalities (e.g., atrial fibrillation).
  
  
  RESULTS
  Among 197 patients (age 67 ± 11 years, 93% male, mean follow-up 4.1 years) enrolled, 30 (15%) were SCA cases and 35 (18%) cardiac non-sudden deaths (C/NS). In multivariate analysis, only heart-rate-corrected QT interval (QTc) predicted SCA (hazard ratio 2.9 [1.2-7.3]) and only depressed heart rate variability (HRV) predicted C/NS (hazard ratio 5.0 [1.5-17.1]) independent of demographic and clinical parameters.
  
  
  CONCLUSIONS
  Among patients with depressed LVEF, prolonged QTc suggests greater potential benefit from ICD therapy to prevent SCA; depressed HRV suggests potential benefit from bi-ventricular pacing to prevent C/NS.
authors.affiliation: Department of Acute and Tertiary Care, School of Nursing, University of Pittsburgh, PA, USA. Electronic address: ssa33@pitt.edu.
authors.forename: Salah S
authors.initials: SS
authors.lastname: Al-Zaiti
authors.affiliation: VA WNY Health Care System at Buffalo, USA; Department of Medicine at The University at Buffalo, NY, USA; Center for Research in Cardiovascular Medicine at The University at Buffalo, NY, USA.
authors.forename: James A
authors.initials: JA
authors.lastname: Fallavollita
authors.affiliation: VA WNY Health Care System at Buffalo, USA; Department of Medicine at The University at Buffalo, NY, USA; Department of Physiology & Biophysics at The University at Buffalo, NY, USA; Department of Biomedical Engineering at The University at Buffalo, NY, USA; Center for Research in Cardiovascular Medicine at The University at Buffalo, NY, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Canty
authors.affiliation: Strong Memorial Hospital at University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Mary G
authors.initials: MG
authors.lastname: Carey
mesh_terms: D000368:Aged; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications*; D011446:Prospective Studies; D016277:Ventricular Function, Left / Q000502:physiology
keywords: Electrocardiogram; Implantable cardioverter defibrillator; Ischemic cardiomyopathy; Sudden cardiac arrest