Prognostic Value of Electrocardiography in Patients With Fulminant Myocarditis Supported by Percutaneous Venoarterial Extracorporeal Membrane Oxygenationã- Analysis From the CHANGE PUMP Study.
Circ J
; 82(8): 2089-2095, 2018 07 25.
Article
em En
| MEDLINE
| ID: mdl-29863096
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).MethodsâandâResults:
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.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Arritmias Cardíacas
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Oxigenação por Membrana Extracorpórea
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Eletrocardiografia
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Miocardite
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article