Ventricular tachycardia risk prediction with an abbreviated duration mobile cardiac telemetry.
Ambulatory ECG
Cardiac arrythmia
Epidemiology
Mobile cardiac telemetry
Prediction
Ventricular tachycardia
Journal
Heart rhythm O2
ISSN: 2666-5018
Titre abrégé: Heart Rhythm O2
Pays: United States
ID NLM: 101768511
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
medline:
30
8
2023
pubmed:
30
8
2023
entrez:
30
8
2023
Statut:
epublish
Résumé
Ventricular tachycardia (VT) occurs intermittently, unpredictably, and has potentially lethal consequences. Our aim was to derive a risk prediction model for VT episodes ≥10 beats detected on 30-day mobile cardiac telemetry based on the first 24 hours of the recording. We included patients who were monitored for 2 to 30 days in the United States using full-disclosure mobile cardiac telemetry, without any VT episode ≥10 beats on the first full recording day. An elastic net prediction model was derived for the outcome of VT ≥10 beats on monitoring days 2 to 30. Potential predictors included age, sex, and electrocardiographic data from the first 24 hours: heart rate; premature atrial and ventricular complexes occurring as singlets, couplets, triplets, and runs; and the fastest rate for each event. The population was randomly split into training (70%) and testing (30%) samples. In a population of 19,781 patients (mean age 65.3 ± 17.1 years, 43.5% men), with a median recording time of 18.6 ± 9.6 days, 1510 patients had at least 1 VT ≥10 beats. The prediction model had good discrimination in the testing sample (area under the receiver-operating characteristic curve 0.7584, 95% confidence interval 0.7340-0.7829). A model excluding age and sex had an equally good discrimination (area under the receiver-operating characteristic curve 0.7579, 95% confidence interval 0.7332-0.7825). In the top quintile of the score, more than 1 in 5 patients had a VT ≥10 beats, while the bottom quintile had a 98.2% negative predictive value. Our model can predict risk of VT ≥10 beats in the near term using variables derived from 24-hour electrocardiography, and could be used to triage patients to extended monitoring.
Sections du résumé
Background
UNASSIGNED
Ventricular tachycardia (VT) occurs intermittently, unpredictably, and has potentially lethal consequences.
Objective
UNASSIGNED
Our aim was to derive a risk prediction model for VT episodes ≥10 beats detected on 30-day mobile cardiac telemetry based on the first 24 hours of the recording.
Methods
UNASSIGNED
We included patients who were monitored for 2 to 30 days in the United States using full-disclosure mobile cardiac telemetry, without any VT episode ≥10 beats on the first full recording day. An elastic net prediction model was derived for the outcome of VT ≥10 beats on monitoring days 2 to 30. Potential predictors included age, sex, and electrocardiographic data from the first 24 hours: heart rate; premature atrial and ventricular complexes occurring as singlets, couplets, triplets, and runs; and the fastest rate for each event. The population was randomly split into training (70%) and testing (30%) samples.
Results
UNASSIGNED
In a population of 19,781 patients (mean age 65.3 ± 17.1 years, 43.5% men), with a median recording time of 18.6 ± 9.6 days, 1510 patients had at least 1 VT ≥10 beats. The prediction model had good discrimination in the testing sample (area under the receiver-operating characteristic curve 0.7584, 95% confidence interval 0.7340-0.7829). A model excluding age and sex had an equally good discrimination (area under the receiver-operating characteristic curve 0.7579, 95% confidence interval 0.7332-0.7825). In the top quintile of the score, more than 1 in 5 patients had a VT ≥10 beats, while the bottom quintile had a 98.2% negative predictive value.
Conclusion
UNASSIGNED
Our model can predict risk of VT ≥10 beats in the near term using variables derived from 24-hour electrocardiography, and could be used to triage patients to extended monitoring.
Identifiants
pubmed: 37645265
doi: 10.1016/j.hroo.2023.06.009
pii: S2666-5018(23)00138-1
pmc: PMC10461200
doi:
Types de publication
Journal Article
Langues
eng
Pagination
500-505Informations de copyright
© 2023 Heart Rhythm Society. Published by Elsevier Inc.
Références
Am J Cardiol. 2019 Feb 1;123(3):409-413
pubmed: 30473328
Am J Cardiol. 2021 Jul 1;150:60-64
pubmed: 34001341
Circulation. 2010 Aug 3;122(5):455-62
pubmed: 20644019
Heart Rhythm O2. 2022 May 16;3(4):344-350
pubmed: 36097468
Eur Heart J. 2019 Jun 14;40(23):1850-1858
pubmed: 30915475
Am J Cardiol. 2016 Nov 15;118(10):1503-1510
pubmed: 27634031
Prog Cardiovasc Dis. 2013 Sep-Oct;56(2):127-32
pubmed: 24215744
Europace. 2019 Mar 18;21(6):844–845
pubmed: 30882141
Clin Med Insights Cardiol. 2015 Jul 08;9(Suppl 2):29-38
pubmed: 26244036
Kardiol Pol. 2022;80(1):49-55
pubmed: 34913475
Br J Sports Med. 2020 Oct;54(19):1142-1148
pubmed: 31481389
Mayo Clin Proc. 2009 Mar;84(3):289-97
pubmed: 19252119
Eur Heart J. 2014 Oct 14;35(39):2733-79
pubmed: 25173338
J Interv Card Electrophysiol. 2018 Jan;51(1):25-33
pubmed: 29305677
J Am Coll Cardiol. 2003 Sep 3;42(5):873-9
pubmed: 12957435
Am J Cardiol. 2015 Mar 1;115(5):630-4
pubmed: 25591894
J Am Coll Cardiol. 2012 Nov 13;60(20):1993-2004
pubmed: 23083773
J Am Coll Cardiol. 2015 Jul 14;66(2):101-9
pubmed: 26160626
Heart Rhythm. 2020 Jul;17(7):1066-1074
pubmed: 32109563
J Am Coll Cardiol. 2005 Mar 1;45(5):697-704
pubmed: 15734613
Arrhythm Electrophysiol Rev. 2017 Aug;6(3):134-139
pubmed: 29018522
J Am Coll Cardiol. 2020 Dec 22;76(25):e159-e240
pubmed: 33229116
Am Fam Physician. 2000 Feb 1;61(3):884, 887-8
pubmed: 10695591