Predictive analysis of QRS wave widen on the incidence of long-term sudden cardiac death during the early phase after acute myocardial infarction

Abstract

Objective To investigate the predictive value of QRS wave widen on the incidence of long-term sudden cardiac death (SCD) during the early phase after acute myocardial infarction (AMI).Methods Two hundred and fifty-nine survived patients with AMI were enrolled.The left ventricular ejection fraction (LVEF) was measured by echocardiography,and the QRS duration and the QTc interval were measured automatically by electrocardiography during the early phase (≤30 d) after AMI.The time of follow-up was (16.5 ± 3.8) months,and the incidence of SCD was observed.The patients were divided into SCD group and survived group according to the follow-up outcome.Results The incidence rate of SCD was 8.1％(21/259).The LVEF in SCD group was significantly lower than that in survived group [(35.8 ± 8.2)％vs.(53.3 ± 6.0)％],and there was statistical difference (P =0.016).The QRS duration was significantly wider than that in survived group [(118.8 ± 15.2) ms vs.(91.5 ± 13.6) ms],and there was statistical difference (P =0.023).There was no statistical difference in QTc interval between the 2 groups (P =0.184).In SCD group,the percentage of patients with decreased LVEF,widen QRS wave and QTc interval prolongation was 42.9％ (9/21),66.7％ (14/21) and 38.1％ (8/21),respectively.The multielement Logistic regression analysis result showed that prehospital electrical conversion/defibrillate (RR =6.514,P =0.011),LVEF decreased (RR =7.325,P =0.005) and QRS wave widen (RR =4.023,P =0.024) were the independent risk factors of SCD.Conclusion QRS wave widen is an independent risk factor for SCD in patients with AMI. Key words: Myocardial infarction; Death,sudden, cardiac; Duration of QRS wave; QTc interval; Left ventricular ejection fraction