Open AccessStandard 12‐Lead and 24‐Hour Ambulatory Electrocardiographic Abnormalities in Survivors of Tachyarrhythmic Cardiac Arrest
Author(s) -
Perkiömäki Juha S.,
Koistinen M. Juhani,
Huikuri Heikki V.
Publication year - 1999
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/j.1542-474x.1999.tb00055.x
Subject(s) - medicine , cardiology , qt interval , ejection fraction , myocardial infarction , ambulatory , electrocardiography , ventricular tachycardia , heart rate , anesthesia , heart failure , blood pressure
Background The aim of the present work was to compare the accuracies of variables obtained from a standard 12‐lead ECG and a 24‐hour ambulatory ECG in discriminating between patients with and patients without tachyarrhythmic cardiac arrest after a previous myocardial infarction. Methods QT c interval and QT c dispersion measured from a 12‐lead ECG and an analysis of ventricular premature depolarization, nonsustained ventricular tachycardia, and heart rate variability from a 24‐hour ECG were compared in survivors of tachyarrhythmic cardiac arrest (n = 57) and in postmyocardial infarction control patients without a history of arrhythmic events and an arrhythmic‐free survival in a 2‐year follow‐up (n = 57). The groups were matched for age, gender, left ventricular ejection fraction, and the usage of beta‐blocking medication. Results QT c dispersion (103 ± 44 vs 71 ± 32 ms, P < 0.001) and the QT c interval maximum, defined as the longest QT c interval in any of the 12 leads of ECG (508 ± 52 vs 459 ± 42 ms, P < 0.001), were longer in the cardiac arrest survivors than in the controls. The standard deviation of R‐R intervals, a measure of heart rate variability, was lower in the cardiac arrest survivors (86 ± 38 vs 108 ± 32 ms, P < 0.001), who had also experienced more commonly ≥; 10 ventricular premature depolarizations/hour (61% vs 35%, P < 0.01) on the 24‐hour ECG. In a stepwise multiple regression analysis, the QT c interval maximum and the standard deviation of R‐R intervals were the most significant independent variables that differed between the groups (P = 0.0002, P = 0.0023, respectively). Their combination yielded a high positive predictive accuracy (91%). Conclusions Simple measurement of the maximum QT c interval from a standard 12‐lead ECG performs equally well or even better than the other more time‐consuming 12‐lead or 24‐hour ambulatory ECG variables in discriminating between patients with a history of tachyarrhythmic cardiac arrest and patients without a history of ventricular tachyarrhythmias after a remote myocardial infarction.