BACKGROUND Abnormal 12-lead electrocardiogram (ECG) can predict cardiovascular events, including sudden cardiac death. We tested the hypothesis that ECG provides useful information on guiding implantable cardioverter defibrillator (ICD) therapy into individuals with impaired left ventricular ejection fraction (LVEF). METHODS Retrospective data of primary prevention ICD implantations from 14 European centers were gathered. The registry included 5111 subjects of whom 1687 patients had an interpretable pre-implantation ECG available (80.0% male, 63.3 ± 11.4 years). Primary outcome was survival without appropriate ICD shocks or heart transplantation. A low-risk ECG was defined as a combination of ECG variables that were associated with the primary outcome. RESULTS A total of 1224 (72.6%) patients survived the follow-up (2.9 ± 1.7 years) without an ICD shock, 224 (13.3%) received an appropriate shock and 260 (15.4%) died. Low-risk ECG defined as QRS duration <120 ms, QTc interval <450 ms for men and <470 ms for women, and sinus rhythm, were met by 515 patients (30.5%). Multivariable Cox regression showed that the hazard (HR) for death, heart transplantation or appropriate shock were reduced by 42.5% in the low-risk group (HR 0.575; 95% CI 0.45-0.74; p < 0.001), compared to the high-risk group. The HR for the first appropriate shock was 42.1% lower (HR 0.58; 95% CI 0.41-0.82; p = 0.002) and the HR for death was 48.0% lower (HR 0.52; 95% CI 0.386-0.72; p < 0.001) in the low-risk group. CONCLUSION Sinus rhythm, QRS <120 ms and normal QTc in standard 12-lead ECG provides information about survival without appropriate ICD shocks and might improve patient selection for primary prevention ICD therapy.

中文翻译：

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心电图可作为原发性预防性ICD患者无适当电击的生存预测指标：一项回顾性多中心研究。

背景技术异常的12导联心电图（ECG）可以预测心血管事件，包括心脏猝死。我们测试了以下假设：ECG可为将植入式心脏复律除颤器（ICD）引导至左心室射血分数（LVEF）受损的个体提供有用的信息。方法收集了来自14个欧洲中心的一级预防性ICD植入的回顾性数据。该注册表包括5111名受试者，其中1687名患者具有可解释的植入前心电图（80.0％男性，63.3±11.4岁）。主要结果是没有适当的ICD休克或心脏移植的生存率。低风险心电图定义为与主要结果相关的心电图变量的组合。结果共有1224（72.6％）名患者幸免于随访（2.9±1）。7年）无ICD休克，有224名（13.3％）受到适当的休克，死亡260名（15.4％）。低风险心电图定义为515例患者（30.5％）满足QRS持续时间<120 ms，男性QTc间隔<450 ms，女性<470 ms，窦性心律。多变量Cox回归显示，低风险组（HR 0.575; 95％CI 0.45-0.74; p <0.001）与高风险组相比，死亡，心脏移植或适当电击的危险（HR）降低了42.5％。风险组。第一次适当电击的HR降低42.1％（HR 0.58; 95％CI 0.41-0.82; p = 0.002），而死亡HR降低48.0％（HR 0.52; 95％CI 0.386-0.72; p <0.001）在低风险组中。结论窦性心律，QRS <