Heart rate-adjusted PR as a prognostic marker of long-term ventricular arrhythmias and cardiac death in ICD/CRT-D recipients  

作　　者：Yu-Qiu LI Shuang ZHAO Ke-Ping CHEN Yang-Gang SU Wei HUA Si-Lin CHEN Zhao-Guang LIANG Wei XU Yan DAI Xiao-Han FAN Shu ZHANG 

机构地区：[1]State Key Laboratory of Cardiovascular Disease,Arrhythmia Center,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China [2]Department of Cardiology,Shanghai Institute of Cardiovascular Diseases,Zhongshan Hospital,Fudan University,Shanghai,China [3]Department of Cardiology,Guangdong Cardiovascular Institute,Guangdong General Hospital,Guangzhou,China [4]Department of Cardiology,First Affiliated Hospital of Harbin Medical University,Harbin,China [5]Department of Cardiology,Nanjing Drum Tower Hospital,Nanjing,China

出　　处：《Journal of Geriatric Cardiology》2019年第3期259-264,共6页老年心脏病学杂志（英文版）

摘　　要：Objective To evaluate the PR to RR interval ratio (PR/RR,heart rate-adjusted PR) as a prognostic marker for long-term ventricular arrhythmias and cardiac death in patients with implantable cardioverter defibrillator (ICDs) and cardiac resynchronization therapy with defibrillators (CRT-D).Methods We retrospectively analyzed data from 428 patients who had an ICD/CRT-D equipped with home monitoring.Baseline PR and RR interval data prior to ICD/CRT-D implantation were collected from standard 12-lead electrocardiograph,and the PR/RR was calculated.The primary endpoint was appropriate ICD/CRT-D treatment of ventricular arrhythmias (VAs),and the secondary endpoint was cardiac death.Results During a mean follow-up period of 38.8 ± 10.6 months,197 patients (46%) experienced VAs,and 47 patients (11%) experienced cardiac death.The overall PR interval was 160 ± 40 ms,and the RR interval was 866 ± 124 ms.Based on the receiver operating characteristic curve,a cut-off value of 18.5% for the PR/RR was identified to predict VAs.A PR/RR ≥ 18.5% was associated with an increased risk of VAs [hazard ratio (HR)= 2.243,95% confidence interval (CI)= 1.665–3.022,P < 0.001) and cardiac death (HR = 2.358,95%CI = 1.240–4.483,P = 0.009) in an unadjusted analysis.After adjustment in a multivariate Cox model,the relationship remained significant among PR/RR ≥ 18.5%,VAs (HR = 2.230,95%CI = 1.555–2.825,P < 0.001) and cardiac death (HR = 2.105,95%CI = 1.101–4.025,P = 0.024.Conclusions A PR/RR ≥ 18.5% at baseline can serve as a predictor of future VAs and cardiac death in ICD/CRT-D recipients.Objective To evaluate the PR to RR interval ratio(PR/RR, heart rate-adjusted PR) as a prognostic marker for long-term ventricular arrhythmias and cardiac death in patients with implantable cardioverter defibrillator(ICDs) and cardiac resynchronization therapy with defibrillators(CRT-D). Methods We retrospectively analyzed data from 428 patients who had an ICD/CRT-D equipped with home monitoring. Baseline PR and RR interval data prior to ICD/CRT-D implantation were collected from standard 12-lead electrocardiograph, and the PR/RR was calculated. The primary endpoint was appropriate ICD/CRT-D treatment of ventricular arrhythmias(VAs), and the secondary endpoint was cardiac death. Results During a mean follow-up period of 38.8 ± 10.6 months, 197 patients(46%) experienced VAs, and 47 patients(11%) experienced cardiac death. The overall PR interval was 160 ± 40 ms, and the RR interval was 866 ± 124 ms. Based on the receiver operating characteristic curve, a cut-off value of 18.5% for the PR/RR was identified to predict VAs. A PR/RR ≥ 18.5% was associated with an increased risk of VAs [hazard ratio(HR) = 2.243, 95% confidence interval(CI) = 1.665–3.022, P < 0.001) and cardiac death(HR = 2.358, 95%CI = 1.240–4.483, P = 0.009) in an unadjusted analysis. After adjustment in a multivariate Cox model, the relationship remained significant among PR/RR ≥ 18.5%, VAs(HR = 2.230, 95%CI = 1.555–2.825, P < 0.001) and cardiac death(HR = 2.105, 95%CI = 1.101–4.025, P = 0.024. Conclusions A PR/RR ≥ 18.5% at baseline can serve as a predictor of future VAs and cardiac death in ICD/CRT-D recipients.

关 键 词：Implantable cardioverter DEFIBRILLATOR PR INTERVAL RR INTERVAL VENTRICULAR ARRHYTHMIAS 

分 类 号：R[医药卫生]