title: 12-Lead electrocardiogram as a predictor of sudden cardiac death: from epidemiology to clinical practice.
abstract: Sudden cardiac death (SCD) causes a high burden of premature deaths in the population affecting subjects of all ages. The identification of subjects at high risk for SCD is of great importance as the prevention of many of these events would be possible with the treatment of underlying cardiac diseases and the use of implantable cardioverter-defibrillators (ICD). However, the current selection of patients for ICD therapy is based solely on left ventricular ejection fraction, and thus a substantial portion of patients at high risk does not qualify for the therapy. Role of the standard electrocardiogram (ECG) in SCD risk stratification has been under active research during the last decade and multiple abnormalities of depolarization and repolarization on the ECG associated with an increased risk of SCD have been identified. In this review, we describe the basic pathophysiological principles behind these changes. We also review the current knowledge of the prognostic significance of ECG predictors of SCD in the general population, and in patients with coronary heart disease (CHD), heart failure, cardiomyopathies, and in inheritable arrhythmia syndromes. Also, insights into the novel digital ECG signal processing techniques are provided.
authors.affiliation: a Department of Internal Medicine , Päijät-Häme Central Hospital , Lahti , Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Eranti
authors.affiliation: b Division of Cardiology , Heart and Lung Center, Helsinki University Central Hospital , Helsinki , Finland.
authors.forename: Aapo L
authors.initials: AL
authors.lastname: Aro
authors.affiliation: c Medical Research Center Oulu, Oulu University Hospital and University of Oulu , Oulu , Finland.
authors.forename: Tuomas
authors.initials: T
authors.lastname: Kenttä
authors.affiliation: b Division of Cardiology , Heart and Lung Center, Helsinki University Central Hospital , Helsinki , Finland.
authors.forename: Arttu
authors.initials: A
authors.lastname: Holkeri
authors.affiliation: c Medical Research Center Oulu, Oulu University Hospital and University of Oulu , Oulu , Finland.
authors.forename: Jani T
authors.initials: JT
authors.lastname: Tikkanen
authors.affiliation: c Medical Research Center Oulu, Oulu University Hospital and University of Oulu , Oulu , Finland.
authors.forename: M Juhani
authors.initials: MJ
authors.lastname: Junttila
authors.affiliation: c Medical Research Center Oulu, Oulu University Hospital and University of Oulu , Oulu , Finland.
authors.forename: Heikki V
authors.initials: HV
authors.lastname: Huikuri
mesh_terms: D000200:Action Potentials; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D003327:Coronary Disease / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D016757:Death, Sudden, Cardiac / Q000453:epidemiology* / Q000517:prevention & control; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000295:instrumentation; D004562:Electrocardiography; D006329:Heart Conduction System / Q000503:physiopathology; D006333:Heart Failure / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D006339:Heart Rate; D006801:Humans; D018579:Patient Selection; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012815:Signal Processing, Computer-Assisted
keywords: Brugada’s syndrome; Death; arrhythmogenic right ventricular dysplasia; cardiac; cardiomyopathy; coronary artery disease; electrocardiography; heart failure; hypertrophic; long QT syndrome; sudden