Abstract
Background: Fulminant myocarditis (FM) presents various abnormal findings on ECG, the prognostic impact of which has not been not fully elucidated. The aim of this study was therefore to clarify the prognostic value of ECG data in FM patients supported by venoarterial extracorporeal membrane oxygenation (VA-ECMO). Methods and Results: In this multicenter chart review, we investigated 99 patients with FM supported by VA-ECMO. The final cohort consisted of 87 patients (mean age, 52±16 years; female, 42%) after 12 patients who required conversion to other forms of mechanical circulatory support were excluded. The median LVEF was 14.5%. At the time of VA-ECMO initiation, 38 patients (44%) had arrhythmias including atrial fibrillation (6%), complete atrioventricular block (CAVB; 17%), and ventricular tachycardia or fibrillation (VT/VF; 15%). Of the 49 patients with sinus rhythm (SR), 26 had QRS duration ≥120 ms (wide QRS). On logistic regression analysis, wide QRS predicted in-hospital death in patients with SR (OR, 3.6; 95% CI: 1.07–13.61, P=0.04). Compared with SR with narrow QRS (QRS duration <120 ms), CAVB and VT/VF had a higher risk of in-hospital death (CAVB: OR, 7.20; 95% CI: 1.78–34.15, P=0.005; VT/VF: OR, 8.10; 95% CI: 1.86–42.31, P=0.005). Conclusions: In patients with FM, CAVB and VT/VF carried a higher risk of in-hospital death. Wide QRS also predicted a higher risk of in-hospital death in patients with SR.
| Original language | English |
|---|---|
| Pages (from-to) | 2089-2095 |
| Number of pages | 7 |
| Journal | Circulation Journal |
| Volume | 82 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - 01-01-2018 |
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All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine
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Prognostic value of electrocardiography in patients with fulminant myocarditis supported by percutaneous venoarterial extracorporeal membrane oxygenation ― Analysis from the change pump study ―. / CHANGE PUMP Investigators.
In: Circulation Journal, Vol. 82, No. 8, 01.01.2018, p. 2089-2095.Research output: Contribution to journal › Article
TY - JOUR
T1 - Prognostic value of electrocardiography in patients with fulminant myocarditis supported by percutaneous venoarterial extracorporeal membrane oxygenation ― Analysis from the change pump study ―
AU - CHANGE PUMP Investigators
AU - Sawamura, Akinori
AU - Okumura, Takahiro
AU - Ito, Masaaki
AU - Ozaki, Yukio
AU - Ohte, Nobuyuki
AU - Amano, Tetsuya
AU - Murohara, Toyoaki
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Background: Fulminant myocarditis (FM) presents various abnormal findings on ECG, the prognostic impact of which has not been not fully elucidated. The aim of this study was therefore to clarify the prognostic value of ECG data in FM patients supported by venoarterial extracorporeal membrane oxygenation (VA-ECMO). Methods and Results: In this multicenter chart review, we investigated 99 patients with FM supported by VA-ECMO. The final cohort consisted of 87 patients (mean age, 52±16 years; female, 42%) after 12 patients who required conversion to other forms of mechanical circulatory support were excluded. The median LVEF was 14.5%. At the time of VA-ECMO initiation, 38 patients (44%) had arrhythmias including atrial fibrillation (6%), complete atrioventricular block (CAVB; 17%), and ventricular tachycardia or fibrillation (VT/VF; 15%). Of the 49 patients with sinus rhythm (SR), 26 had QRS duration ≥120 ms (wide QRS). On logistic regression analysis, wide QRS predicted in-hospital death in patients with SR (OR, 3.6; 95% CI: 1.07–13.61, P=0.04). Compared with SR with narrow QRS (QRS duration <120 ms), CAVB and VT/VF had a higher risk of in-hospital death (CAVB: OR, 7.20; 95% CI: 1.78–34.15, P=0.005; VT/VF: OR, 8.10; 95% CI: 1.86–42.31, P=0.005). Conclusions: In patients with FM, CAVB and VT/VF carried a higher risk of in-hospital death. Wide QRS also predicted a higher risk of in-hospital death in patients with SR.
AB - Background: Fulminant myocarditis (FM) presents various abnormal findings on ECG, the prognostic impact of which has not been not fully elucidated. The aim of this study was therefore to clarify the prognostic value of ECG data in FM patients supported by venoarterial extracorporeal membrane oxygenation (VA-ECMO). Methods and Results: In this multicenter chart review, we investigated 99 patients with FM supported by VA-ECMO. The final cohort consisted of 87 patients (mean age, 52±16 years; female, 42%) after 12 patients who required conversion to other forms of mechanical circulatory support were excluded. The median LVEF was 14.5%. At the time of VA-ECMO initiation, 38 patients (44%) had arrhythmias including atrial fibrillation (6%), complete atrioventricular block (CAVB; 17%), and ventricular tachycardia or fibrillation (VT/VF; 15%). Of the 49 patients with sinus rhythm (SR), 26 had QRS duration ≥120 ms (wide QRS). On logistic regression analysis, wide QRS predicted in-hospital death in patients with SR (OR, 3.6; 95% CI: 1.07–13.61, P=0.04). Compared with SR with narrow QRS (QRS duration <120 ms), CAVB and VT/VF had a higher risk of in-hospital death (CAVB: OR, 7.20; 95% CI: 1.78–34.15, P=0.005; VT/VF: OR, 8.10; 95% CI: 1.86–42.31, P=0.005). Conclusions: In patients with FM, CAVB and VT/VF carried a higher risk of in-hospital death. Wide QRS also predicted a higher risk of in-hospital death in patients with SR.
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U2 - 10.1253/circj.CJ-18-0136
DO - 10.1253/circj.CJ-18-0136
M3 - Article
C2 - 29863096
AN - SCOPUS:85050584246
VL - 82
SP - 2089
EP - 2095
JO - Circulation Journal
JF - Circulation Journal
SN - 1346-9843
IS - 8
ER -