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Ventricular tachycardia risk prediction with an abbreviated duration mobile cardiac telemetry

Economou Lundeberg, Johan LU orcid ; Måneheim, Alexandra LU ; Persson, Anders LU orcid ; Dziubinski, Marek ; Sridhar, Arun ; Healey, Jeffrey S. ; Slusarczyk, Magdalena ; Engström, Gunnar LU and Johnson, Linda S. LU (2023) In Heart Rhythm O2 4(8). p.500-505
Abstract

Background: Ventricular tachycardia (VT) occurs intermittently, unpredictably, and has potentially lethal consequences. Objective: 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: 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... (More)

Background: Ventricular tachycardia (VT) occurs intermittently, unpredictably, and has potentially lethal consequences. Objective: 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: 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: 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: 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.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Ambulatory ECG, Cardiac arrythmia, Epidemiology, Mobile cardiac telemetry, Prediction, Ventricular tachycardia
in
Heart Rhythm O2
volume
4
issue
8
pages
6 pages
publisher
Elsevier
external identifiers
  • pmid:37645265
  • scopus:85165070084
ISSN
2666-5018
DOI
10.1016/j.hroo.2023.06.009
language
English
LU publication?
yes
id
432e2e41-f95a-488d-bc18-1d46f8b89c54
date added to LUP
2023-09-27 11:38:15
date last changed
2024-04-19 01:44:23
@article{432e2e41-f95a-488d-bc18-1d46f8b89c54,
  abstract     = {{<p>Background: Ventricular tachycardia (VT) occurs intermittently, unpredictably, and has potentially lethal consequences. Objective: 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: 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: 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: 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.</p>}},
  author       = {{Economou Lundeberg, Johan and Måneheim, Alexandra and Persson, Anders and Dziubinski, Marek and Sridhar, Arun and Healey, Jeffrey S. and Slusarczyk, Magdalena and Engström, Gunnar and Johnson, Linda S.}},
  issn         = {{2666-5018}},
  keywords     = {{Ambulatory ECG; Cardiac arrythmia; Epidemiology; Mobile cardiac telemetry; Prediction; Ventricular tachycardia}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{500--505}},
  publisher    = {{Elsevier}},
  series       = {{Heart Rhythm O2}},
  title        = {{Ventricular tachycardia risk prediction with an abbreviated duration mobile cardiac telemetry}},
  url          = {{http://dx.doi.org/10.1016/j.hroo.2023.06.009}},
  doi          = {{10.1016/j.hroo.2023.06.009}},
  volume       = {{4}},
  year         = {{2023}},
}