Ventricular tachycardia risk prediction with an abbreviated duration mobile cardiac telemetry
(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.
(Less)
- author
- Economou Lundeberg, Johan LU ; Måneheim, Alexandra LU ; Persson, Anders LU ; Dziubinski, Marek ; Sridhar, Arun ; Healey, Jeffrey S. ; Slusarczyk, Magdalena ; Engström, Gunnar LU and Johnson, Linda S. LU
- organization
- publishing date
- 2023-08
- 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
-
- scopus:85165070084
- pmid:37645265
- 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
- 2024-07-12 09:19:11
@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}}, }