In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 130, No. suppl_2 ( 2014-11-25)
Abstract:
Background: Fragmented QRS (fQRS) in 12-lead ECG, ascribed to myocardial scar, has been shown to predict future cardiac events in patients with both ischemic and non-ischemic dilated cardiomyopathy (NIDCM). Various definitions and low specificity of fQRS, however, limited its use. We hypothesized that the advantage of 64-channel magnetocardiography (MCG), i.e., high spatio-temporal resolution, enables more accurate detection of fragmented LV conduction (fLV), that would lead to accurate prediction of future events. Methods: In 51 patients with NIDCM and narrow QRS (LVEF, 22±7%; QRS duration, 99±11 ms), we recorded MCG. We defined, in MCG superimposed vector magnitude waveforms, fLV as distinct abnormal components ( 〉 20% of maximal amplitude). In current arrow map, fLV corresponded to heterogeneous QRS currents (Figure). We predicted major adverse cardiac events (MACE), including sudden cardiac death (SCD), sustained ventricular tachyarrhythmias (VF/VT), appropriate defibrillator discharge (Def) and left ventricular assist device implantation (LVAD). Results: fLV was present in 27 (Group-F) and not in 24 (Group-N). Age, gender, ECG and echocardiographic findings, laboratory data and medications were similar irrespective of fLV. During a mean follow-up of 2.2 years, MACE occurred in 19 (4 SCD, 9 VF/VT, 2 Def, and 4 LVAD). MACE more frequently occurred with fLV (63%, 17/27) than without (8%, 2/24, Kaplan-Meier analysis, p 〈 0.001). Multivariate analysis revealed fLV as the only independent predictor of MACE (HR 4.82, p=0.015). Conclusion: MCG analysis is a promising noninvasive tool to accurately detect fragmentation and predict MACE in patients with NIDCM and normal QRS.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/circ.130.suppl_2.17191
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2014
detail.hit.zdb_id:
1466401-X
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