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Hadid - Almendral - PL VT on ICD EG - CircAE 2011.pdf2,86 MBAdobe PDF Accés restringit

Citació: Hadid, C. [et al.]. Incidence, determinants, and prognostic implications of true pleomorphism of ventricular tachycardia in patients with implantable cardioverter-defribillators: a substudy of the DATAS trial. "Circulation. Arrhythmia and electrophysiology", 2011, vol. 4, núm. 1, p. 33-42.
Títol: Incidence, determinants, and prognostic implications of true pleomorphism of ventricular tachycardia in patients with implantable cardioverter-defribillators: a substudy of the DATAS trial
Autor: Quesada, Aurelio; Navarro, Xavier; Cobo Valeri, Erik Veure Producció científica UPC; Adragao, Pedro; Ricci, Renato; Hadid, Claudio; Almendral, Jesús; Ortiz, Mercedes; Schwab, Joerg Otto; Janko, Sabine; Mischke, Karl; Arribas, Fernando; Wolpert, Christian
Data: 2011
Tipus de document: Article
Resum: Background— The occurrence of monomorphic ventricular tachycardia (M-VT) with >1 QRS morphology during the same episode (pleomorphism [PL]) or in different episodes (multiple morphologies [MM]) has been described through ECG. Implantable cardioverter-defribillator (ICD) electrograms (EGs) provide the opportunity to analyze virtually all spontaneous M-VT episodes. We sought to study the incidence, determinants, and prognostic significance of PL and MM as assessed by ICD-EG in a prospective series of patients with ICDs. Methods and Results— Spontaneous episodes of M-VT were analyzed before ICD intervention. PL was defined as >1 ICD-EG morphology, each having ≥6 consecutive identical beats during the same VT episode, and MM as >1 ICD-EG morphology in different M-VT episodes in the same patient. We analyzed 1881 M-VT episodes from 315 patients followed for 17 months. PL and MM occurred in 6% and 19%, respectively, of the total population (16% and 62% of patients with M-VT). Recurrent M-VT as diagnosis for ICD indication predicted PL and MM. Patients with PL more frequently developed MM (85% versus 15%; P<0.001) compared to patients without PL. Total mortality (5%) was significantly higher in patients with PL (20%), in patients with MM (11.5%), and in women (12%). In multivariate analysis, only PL (odds ratio, 5.33; P=0.009) and female sex (odds ratio, 3.1; P=0.038) predicted mortality. Conclusions— In a prospective series of patients with ICDs, mostly indicated for secondary prevention, both PL and MM of VT, as judged by ICD-EG, were not uncommon and were strongly associated. Female sex and the development of PL VT were the only independent predictors of mortality.
ISSN: 1941-3149
URI: http://hdl.handle.net/2117/11610
DOI: 10.1161/CIRCEP.110.957068
Apareix a les col·leccions:GREMA - Grup de Recerca en Estadística Matemàtica i les seves Aplicacions. Articles de revista
Departament d'Estadística i Investigació Operativa. Articles de revista
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