Skip Navigation



Europace Advance Access published online on October 25, 2007
Europace, doi:10.1093/europace/eum228
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
9/12/1203    most recent
eum228v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Gallagher, M. M.
Right arrow Articles by Romeo, F.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gallagher, M. M.
Right arrow Articles by Romeo, F.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2007. For permissions please email: journals.permissions@oxfordjournals.org

Electrocardiographic markers of structural heart disease and predictors of death in 2332 unselected patients undergoing outpatient Holter recording

Mark M. Gallagher1,*, Mina Padula1, Marianna Sgueglia1, Luca Santini1, Paolo Voci1, Niall G. Mahon2, Yee Guan Yap3 and Francesco Romeo1

1 Department of Cardiology, Policlinico Tor Vergata, Viale Oxford 81, Rome 00133, Italy; 2 Department of Cardiology, Mater Hospital, Dublin, Ireland; 3 Department of Medicine, University Putra Malaysia, Kuala Lumpur, Malaysia

Aims: To test the hypothesis that the QS interval of ventricular ectopic beats (VEBs) (ventricular ectopic QS interval, VEQSI) would provide a marker for the presence of structural heart disease and a predictor of mortality.

Methods and results: We interviewed and examined 2332 patients undergoing Holter ECG monitoring for clinical indications. In persons with VEBs, the morphologies were counted and the QS interval was measured for each of these morphologies. The duration of the broadest VEB, measured from the QRS onset in the derivation showing the earliest onset to its end in the derivation showing the latest termination, was taken as that patient's VEQSI. Survival was ascertained from public health records. Of 15 electrocardiographic variables pre-selected as potential prognostic indicators, VEQSI demonstrated the strongest association with the presence of structural heart disease (P = 0.013). Thirty-four persons died in 16 ± 4 months follow-up. Univariate predictors of mortality are age, history of myocardial infarction, maximum heart rate, QS interval, the number of VEB morphologies, and the VEQSI. On multivariate analysis, only age (P < 0.001) and the number of VEB morphologies (P = 0.02) predicted mortality.

Conclusion: VEQSI predicts the presence of structural heart disease. The number of VEB morphologies in a Holter recording predicts all-cause mortality.

Key Words: Risk stratification, Sudden death, Ventricular fibrillation, QRS complex duration, QRS interval, Ventricular ectopic beat, Ventricular premature beat, Heart rate variability, Myocardial infarction

* Corresponding author. Tel: +39 03478993059; fax: +39 0620900382.E-mail address: mark_m_gallagher{at}hotmail.com

Manuscript submitted 30 April 2007. Accepted after revision 14 September 2007.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.