Universität zu Köln

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:	Creators Email ORCID ORCID Put Code Campbell, Matthew UNSPECIFIED orcid.org/0000-0002-0218-3619 UNSPECIFIED Moore, Jeremy P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sreeram, Narayanswami UNSPECIFIED UNSPECIFIED UNSPECIFIED von Alvensleben, Johannes C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Shah, Anjan UNSPECIFIED UNSPECIFIED UNSPECIFIED Batra, Anjan UNSPECIFIED UNSPECIFIED UNSPECIFIED Law, Ian UNSPECIFIED orcid.org/0000-0001-7309-6005 UNSPECIFIED Sanatani, Shubhayan UNSPECIFIED orcid.org/0000-0001-9296-7400 UNSPECIFIED Thomas, Vincent UNSPECIFIED UNSPECIFIED UNSPECIFIED Nik-Ahd, Farnoosh UNSPECIFIED UNSPECIFIED UNSPECIFIED Williams, Stephen UNSPECIFIED UNSPECIFIED UNSPECIFIED Nosavan, Nina UNSPECIFIED UNSPECIFIED UNSPECIFIED Maldonado, Jennifer UNSPECIFIED UNSPECIFIED UNSPECIFIED Hart, Amelia UNSPECIFIED UNSPECIFIED UNSPECIFIED Balaji, Seshadri UNSPECIFIED UNSPECIFIED UNSPECIFIED
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:	Keywords Language CONGENITAL HEART-DISEASE; PEDIATRIC-PATIENTS; YOUNG-ADULTS; COMPLICATIONS; THERAPY Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18788