Campbell, Matthew ORCID: 0000-0002-0218-3619, Moore, Jeremy P., Sreeram, Narayanswami, von Alvensleben, Johannes C., Shah, Anjan, Batra, Anjan, Law, Ian ORCID: 0000-0001-7309-6005, Sanatani, Shubhayan ORCID: 0000-0001-9296-7400, Thomas, Vincent, Nik-Ahd, Farnoosh, Williams, Stephen, Nosavan, Nina, Maldonado, Jennifer, Hart, Amelia and Balaji, Seshadri (2018). Predictors of electrocardiographic screening failure for the subcutaneous implantable cardioverter-defibrillator in children: A prospective multicenter study. Heart Rhythm, 15 (5). S. 703 - 708. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1556-3871

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Abstract

BACKGROUND Subcutaneous implantable cardioverter-defibrillator (SICD) shows promise for select patients at risk of sudden cardiac death. However, patients need to pass an electrocardiographic (ECG) screening (ECG-S) test before they can receive an SICD. Predictors of ECG-S failure in children are unclear. OBJECTIVE The purpose of this study was to identify the incidence and predictive factors for failure of ECG-S in children. METHODS Patients 18 years and younger with a preexisting ICD underwent ECG-S for SICD. ECG and demographic data were analyzed for factors predictive of failure. RESULTS Seventy-three patients (mean age 14.2 +/- 3.3 years; range 5-18 years) with hypertrophic cardiomyopathy (n = 24, 33%), long QT syndrome (n =18, 25%), other inherited arrhythmia syndromes (n = 20, 27%), congenital heart disease (n = 9, 12%), and miscellaneous conditions (n = 2) with an existing transvenous ICD underwent prospective ECG-S. Nineteen (26%) failed ECG-S. Failed patients had a longer corrected QT (QTc) interval (457 ms vs 425 ms; P = .03), a longer QRS duration (120 ms vs 98 ms; P = .04), and a lower ratio of R-wave to T-wave amplitudes (R:T ratio) in lead aVF (4 vs 5; P = .001). Multivariable logistic regression identified QTc interval (odds ratio [OR] 4.31; P = .04), QRS duration (OR 4.93; P = .03), R:T ratio in lead aVF (OR 3.13; P = .08) as predictors of failure. A risk score with 1 point each for QTc interval >440 ms, QRS duration >120 ms, and R:T ratio <6.5 in lead aVF was associated with probability of failure of 15.4% (1 point), 47.4 0 /. (2 points), and 88.6% (3 points), respectively. CONCLUSION ECG-S failure for SICD occurred in 26% of children, which is higher than the reported incidence in adults. Factors predicting ECG-S failure included longer QTc interval, longer QRS duration, and lower R:T ratio in lead aVF.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Campbell, MatthewUNSPECIFIEDorcid.org/0000-0002-0218-3619UNSPECIFIED
Moore, Jeremy P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sreeram, NarayanswamiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
von Alvensleben, Johannes C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Shah, AnjanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Batra, AnjanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Law, IanUNSPECIFIEDorcid.org/0000-0001-7309-6005UNSPECIFIED
Sanatani, ShubhayanUNSPECIFIEDorcid.org/0000-0001-9296-7400UNSPECIFIED
Thomas, VincentUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nik-Ahd, FarnooshUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Williams, StephenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nosavan, NinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maldonado, JenniferUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hart, AmeliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Balaji, SeshadriUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-187881
DOI: 10.1016/j.hrthm.2018.01.004
Journal or Publication Title: Heart Rhythm
Volume: 15
Number: 5
Page Range: S. 703 - 708
Date: 2018
Publisher: ELSEVIER SCIENCE INC
Place of Publication: NEW YORK
ISSN: 1556-3871
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
CONGENITAL HEART-DISEASE; PEDIATRIC-PATIENTS; YOUNG-ADULTS; COMPLICATIONS; THERAPYMultiple languages
Cardiac & Cardiovascular SystemsMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/18788

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