Clinical Study Of Sudden Cardiac Death In Patients With Predictive Heart Failure By Theambulatory ECG-based TWA

Objective:To assess the predictive value of sudden cardiac death(SCD)by 24-hour ambulatory ECGs(AECGs)by modified moving average technique(MMA)However,the current AECGs-MTWA prediction of sudden death from heart failure has not been reported in the country.In this study,a retrospective clinical study of patients with chronic heart failure to explore AECGs-MTWA predicted sudden death in patients with heart failure cut-off value.Methods:A total of 220 patients with chronic heart failure admitted to Liaocheng People's Hospital from June 2009 to June 2016 were enrolled.The 24-hour ambulatory electrocardiogram(MTWA)was analyzed by MMA technique using the MARSPC system(GE Healthcare,Milwaukee,WI,USA)8-point TWA and TWAmax were divided into SCD group,Non-SCD group,survival group according to the primary endpoint events and secondary endpoint events by outpatient review or telephone follow-up.Receiver operating curve(ROC curve),respectively,to obtain the best cut-off point of each index mV1 and mV3.Results:There was a significant correlation between TWA(maximal TWA)and sudden cardiac death(SCD)at 8:00 am on the mV1 and the mV3 at 8:00 am.According to the ROC curve,mV1 TWAmax cut-off value of 40 uV,sensitivity 89.5%,specificity 71.8%,under the curve area 0.879,95% confidence interval(0.788-0.969);mV1 8:00 am TWA cut-off value of 8uV,the sensitivity of 73.7%,Specificity of 97.4%,under the curve area of 0.929,95% confidence interval(0.863-0.996).mV3 TWAmax cut-off 46 uV,sensitivity 84.2%,specificity 91%,under the curve area 0.898,95% confidence interval(0.802-0.993);mV3 8:00 am TWA cut-off value of 7uV,the sensitivity of 78.9%,Specificity of 73.1%,under the curve area 0.882,95% confidence interval(0.801-0.963).The sensitivity of TWAmax to mV1 in predicting sudden cardiac death was greater than that of mV3 but less specific than that of mV3.The sensitivity of 8: 00 aMTWA to predict sudden cardiac death in V1 was less than that of mV3 but more specific than mV3.Conclusions:1.AECGs-MTWA can predict sudden cardiac death in patients with chronic heart failure.2.AECGs-MTWA predicts the cut-off point of sudden death in heart failure: the optimal cut-off point of TWAmax in mV1 lead is 40 uV,the best cut-off point of MTWA in 8:00am is 8uV;the optimal cut-off point of TWAmax in mV3 lead is 46 uV,the best cut-off point of MTWA in 8:00am is 7uV.