Ventricular Tachycardia Risk Prediction with an Abbreviated Duration Mobile Cardiac Telemetry.
Heart rhythm O2(2023)
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 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 6 17.1 years, 43.5% men), with a median recording time of 18.669.6 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 receiveroperating 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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Key words
Ventricular tachycardia,Ambulatory ECG,Prediction,Cardiac arrythmia,Mobile cardiac telemetry,Epidemiology
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