Author + information
- Wan-Tai Michael Au-Yeung,
- Jennifer Boughner,
- Hans Moore,
- Ross Fletcher,
- George Johnson,
- Jill Anderson,
- Jeanne Poole,
- Daniel Mark,
- Kerry Lee,
- Gust Bardy and
- Per Reinhall
SCD-HeFT included 2,521 patients with NYHA class II or III heart failure (HF) and ejection fraction less than or equal to 35%. We hypothesized that turbulence slope (TS) and alpha1 (short-term fractal exponent from Detrended Fluctuation Analysis) of HF patients can be correlated to the necessity of Implantable Cardioverter Defibrillator (ICD) therapy. If these measures are combined together, one can better identify non-candidates for ICD therapy.
We attempted to find TS and alpha1 for 258 patients, randomly chosen from the SCD-HeFT population, and compared to 54 healthy subjects. They were correlated to three endpoints at the end of 45.5 months of follow-up: Sudden Tachyarrhythmia, Other Forms of Death and Alive. All subjects were plotted on a scatter plot with TS and alpha1 as the axes to provide separation between groups.
The TS and alpha1 of Sudden Tachyarrhythmia group are the lowest and they increase as the conditions of the groups get better. On the figure, we set a threshold line with TS-intercept at 12.5 and alpha1-intercept at .76. If only HF patients who fall below the threshold line receive ICD therapy, we exclude 44.6% of patients from ICD therapy while achieving 91.7% sensitivity, 51.6% specificity and 97.4% negative predictive value.
Both TS and alpha1 are correlated to the mortality of HF patients. We exclude 44.6% of HF patients in SCD-HeFT from ICD therapy by setting a threshold line with TS-intercept at 12.5 and alpha1-intercept at .76 on the scatter plot.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Heart Failure: Therapeutic Insights
Abstract Category: 17. Heart Failure: Therapy
Presentation Number: 1306-270
- 2013 American College of Cardiology Foundation