Electrocardiographic associations with myocardial fibrosis among sudden cardiac death victims
- 22 March 2020
- Vol. 106 (13), 1001-1006
- https://doi.org/10.1136/heartjnl-2019-316105
Abstract
Objective A major challenge in reducing the incidence of sudden cardiac death (SCD) is the identification of patients at risk. Myocardial fibrosis has a substantial association with SCD risk but is difficult to identify among general populations. Our aim was to find electrocardiographic (ECG) markers of myocardial fibrosis among SCD victims. Methods Study population was acquired from the Fingesture study, which has gathered data from 5869 consecutive autopsied SCD victims in Northern Finland between 1998 and 2017. The degree of fibrosis was determined in histological samples taken from the heart during autopsy and was categorised into four groups: (1) no fibrosis, (2) scattered mild fibrosis, (3) moderate patchy fibrosis and (4) substantial fibrosis. We were able to collect ECGs from 1100 SCD victims. Results The mean age of the study subjects was 66±13 years and 75% were male. QRS duration in ECG correlated with the degree of fibrosis (pConclusions Myocardial fibrosis was associated with QRS prolongation, deep Q waves, T wave inversions and QRS fragmentation. The results provide potentially useful non-invasive early recognition of patients with fibrotic cardiomyopathy and risk of SCD.Keywords
Funding Information
- Suomen Lääketieteen Säätiö
- Aarne Koskelon Säätiö
- Paavo Nurmen Säätiö
- Yrjö Jahnssonin Säätiö
- Jane ja Aatos Erkon Säätiö
- Paulon Säätiö
- Sydäntutkimussäätiö
- Sigrid Juséliuksen Säätiö
This publication has 28 references indexed in Scilit:
- Association of Early Repolarization and Sudden Cardiac Death During an Acute Coronary EventCirculation: Arrhythmia and Electrophysiology, 2012
- Sudden Cardiac Death Caused by Coronary Heart DiseaseCell Metabolism, 2012
- Relation of Positive T Wave in Lead aVR to Risk of Cardiovascular MortalityThe American Journal of Cardiology, 2011
- Intraventricular Conduction Delay in a Standard 12-Lead Electrocardiogram as a Predictor of Mortality in the General PopulationCirculation: Arrhythmia and Electrophysiology, 2011
- Causes of nonischemic sudden cardiac death in the current eraHeart Rhythm, 2011
- Assessment of Nonischemic Myocardial FibrosisJournal of the American College of Cardiology, 2010
- Long-Term Outcome Associated with Early Repolarization on ElectrocardiographyNew England Journal of Medicine, 2009
- AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the ElectrocardiogramJournal of the American College of Cardiology, 2009
- Significance of a Fragmented QRS Complex Versus a Q Wave in Patients With Coronary Artery DiseaseCell Metabolism, 2006
- Population-Based Analysis of Sudden Cardiac Death With and Without Left Ventricular Systolic DysfunctionJournal of the American College of Cardiology, 2006