Impact of T wave amplitude in lead aVR on predicting cardiac events in ischemic and nonischemic cardiomyopathy patients with an implantable cardioverter defibrillator

Background T wave amplitudes during ventricular repolarization in the lead aVR ( TA a VR ) are shown to be associated with adverse cardiac events in patients with several cardiovascular diseases, such as postmyocardial infarction. However, the utility of TA a VR has not been previously evaluated in patients with cardiomyopathy who have received implantable cardioverter defibrillators ( ICD ). Patients with ischemic or nonischemic cardiomyopathy ( ICM or NICM , respectively) and who received an ICD may experience worsening of their condition due to the introduction of electric shock during treatment. This study aimed to investigate the utility of TA a VR in the prediction of cardiac events in ICM or NICM patients with ICD . Methods Ninety‐three consecutive ICM or NICM patients with ICD were retrospectively analyzed (median age: 64 years; male: 77.4%; ICD for secondary prevention: 76.3%; NICM : 64.5%). The median follow‐up period was 31 months. The primary endpoint was defined as composite cardiac events, including cardiac death, major ventricular arrhythmic events ( MVAE ), or hospitalization due to heart failure ( HHF ). Results Multivariate Cox regression analysis demonstrated that less negative TA a VR (−0.1 mV ≤ TA a VR <0 mV and 0 mV ≤  TA a VR ) was independently associated with the primary endpoint ( HR : 3.75; 95% confidence interval [ CI ]: 1.09–23.7; p  = .04). Kaplan – Meier curve also revealed that the event free survival rate in the less negative TA a VR group was significantly lower than that in the normal TA a VR group (<−0.1 mV) ( p  < .01). Conclusions TA a VR is useful in risk stratification for cardiac events in ICM or NICM patients with ICD .