Risk stratification for cardiac mortality using electrocardiographic markers based on 24-hour Holter recordings: the JANIES-SHD study

Kinoshita, Toshio; Hashimoto, Kazuhito; Yoshioka, Koichiro; Miwa, Yosuke; Yodogawa, Kenji; Watanabe, Eiichi; Nakamura, Kohki; Nakagawa, Mikiko; Nakamura, Kentaro; Watanabe, Tetsu; Yusu, Satoru; Tachibana, Motomi; Mizumaki, Koichi; Ikeda, Takanori

doi:10.1016/j.jjcc.2019.07.012

Cited by 21 publications

(31 citation statements)

References 37 publications

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“…Non‐invasive risk factors criteria from SAECG and 24‐hour AECG for electrical instability predisposing to possible future malignant arrhythmias included: Presence of Late Potentials diagnosed if 2 out of 3 conventional 19 or modified 20 criteria were present (acceptable noise level < 0.6 μV). One or more non‐sustained ventricular tachycardia (NSVT) episodes 21 (at least three QRS complexes at a rate of ≥ 100 beats per minute) on 24‐hour AECG. Ventricular premature beats ≥ 240/24 hours 22 on 24‐hour AECG. …”

Section: Methodsmentioning

confidence: 99%

Arrhythmic risk stratification in heart failure mid‐range ejection fraction patients with a non‐invasive guiding to programmed ventricular stimulation two‐step approach

Αρσένος

Antoniou

Doundoulakis

et al. 2020

Journal of Arrhythmia

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Section: Methodsmentioning

confidence: 99%

Arrhythmic risk stratification in heart failure mid‐range ejection fraction patients with a non‐invasive guiding to programmed ventricular stimulation two‐step approach

Αρσένος

Antoniou

Doundoulakis

et al. 2020

Journal of Arrhythmia

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“…In patients with structural heart disease with left ventricular dysfunction but relatively preserved LVEF, a combination of HRT category 2 and the presence of non-sustained ventricular tachycardia allowed a better prediction of all-cause mortality and fatal arrhythmic events compared to the single parameters (Kinoshita et al, 2019). Further research is warranted to evaluate if ECG based risk prediction might be of use in hemodialysis patients as well.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Mortality Can Be Predicted by Heart Rate Turbulence in Hemodialysis Patients

et al. 2020

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Background: Excess mortality in hemodialysis patients is mostly of cardiovascular origin. We examined the association of heart rate turbulence (HRT), a marker of baroreflex sensitivity, with cardiovascular mortality in hemodialysis patients. Methods: A population of 290 prevalent hemodialysis patients was followed up for a median of 3 years. HRT categories 0 (both turbulence onset [TO] and slope [TS] normal), 1 (TO or TS abnormal), and 2 (both TO and TS abnormal) were obtained from 24 h Holter recordings. The primary end-point was cardiovascular mortality. Associations of HRT categories with the endpoints were analyzed by multivariable Cox regression models including HRT, age, albumin, and the improved Charlson Comorbidity Index for hemodialysis patients. Multivariable linear regression analysis identified factors associated with TO and TS. Results: During the follow-up period, 20 patients died from cardiovascular causes. In patients with HRT categories 0, 1 and 2, cardiovascular mortality was 1, 10, and 22%, respectively. HRT category 2 showed the strongest independent association with cardiovascular mortality with a hazard ratio of 19.3 (95% confidence interval: 3.69-92.03; P < 0.001). Age, calcium phosphate product, and smoking status were associated with TO and TS. Diabetes mellitus and diastolic blood pressure were only associated with TS.

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“…This study was a substudy of the Japanese Noninvasive Electrocardiographic Risk Stratification for Prediction of Sudden Cardiac Death (JANIES) study (Kinoshita et al., 2020). The JANIES study was designed as a multicenter, observational, prospective cohort study and evaluated noninvasive ECG indices, such as LPs, HRT, and NSVT, which can be analyzed simultaneously using a 24‐hr digital AECG, to predict cardiac mortality and/or lethal arrhythmias in high‐risk patients.…”

Section: Methodsmentioning

confidence: 99%

“…Participants in the substudy were enrolled between April 2012 and March 2015. Inclusion and exclusion criteria used in this study are reported elsewhere (Kinoshita et al., 2020). Briefly, the patients with structural or idiopathic cardiac disorder who underwent 24‐hr high‐resolution digital ambulatory monitoring were included.…”

Section: Methodsmentioning

confidence: 99%

Combined evaluation of ambulatory‐based late potentials and nonsustained ventricular tachycardia to predict arrhythmic events in patients with previous myocardial infarction: A Japanese noninvasive electrocardiographic risk stratification of sudden cardiac death (JANIES) substudy

Hashimoto

Amino

Yoshioka

et al. 2020

Noninvasive Electrocardiol

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Background Noninvasive electrocardiographic (ECG) markers are promising arrhythmic risk stratification tools for identifying sudden cardiac death. However, little is known about the usefulness of noninvasive ECG markers derived from ambulatory ECGs (AECG) in patients with previous myocardial infarction (pMI). We aimed to determine whether the ECG markers derived from AECG can predict serious cardiac events in patients with pMI. Methods We prospectively analyzed 104 patients with pMI (88 males, age 66 ± 11 years), evaluating late potentials (LPs), heart rate turbulence, and nonsustained ventricular tachycardia (NSVT) derived from AECG. The primary endpoint was the documentation of ventricular fibrillation or sustained ventricular tachycardia. Results Eleven patients reached the primary endpoint during a follow‐up period of 25 ± 9.5 months. Of the 104 patients enrolled in this study, LP positive in worst values (w‐LPs) and NSVT were observed in 25 patients, respectively. In the arrhythmic event group, the worst LP values and/or NSVT were found in eight patients (7.6%). The positive predictive and negative predictive values of the combined assessment with w‐LPs and NSVT were 56% and 94%, respectively, for predicting ventricular lethal arrhythmia. Kaplan–Meier analysis demonstrated that the combination of w‐LPs and NSVT had a poorer event‐free period than negative LPs (p < .0001). In the multivariate analysis, the combined assessment of w‐LPs and NSVT was a significant predictor of arrhythmic events (hazard ratio = 14.1, 95% confidence intervals: 3.4–58.9, p < .0001). Conclusion Combined evaluation of w‐LPs and NSVT was a powerful risk stratification strategy for predicting arrhythmia that can lead to sudden cardiac death in patients with pMI.

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Risk stratification for cardiac mortality using electrocardiographic markers based on 24-hour Holter recordings: the JANIES-SHD study

Cited by 21 publications

References 37 publications

Arrhythmic risk stratification in heart failure mid‐range ejection fraction patients with a non‐invasive guiding to programmed ventricular stimulation two‐step approach

Arrhythmic risk stratification in heart failure mid‐range ejection fraction patients with a non‐invasive guiding to programmed ventricular stimulation two‐step approach

Cardiovascular Mortality Can Be Predicted by Heart Rate Turbulence in Hemodialysis Patients

Combined evaluation of ambulatory‐based late potentials and nonsustained ventricular tachycardia to predict arrhythmic events in patients with previous myocardial infarction: A Japanese noninvasive electrocardiographic risk stratification of sudden cardiac death (JANIES) substudy

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