Abstract
Background Performance of ambulatory electrocardiography (AECG) may provide data useful for counseling patients regarding prognosis and for selecting potential patients for defibrillator implantation, but this practice remains controversial. Methods We reviewed clinical and AECG data on 355 patients diagnosed with dilated cardiomyopathy (DCM). Predictors of survival were identified in a multivariable analysis using a Cox proportional hazard model. Ability of the derived model to predict outcomes was tested using a second cohort of 144 patients. Results Nonsustained ventricular tachycardia (NSVT) was present on AECG in 31% of the subjects. Ambulatory electrocardiography provided 3 independent predictors of mortality: NSVT (relative risk [RR], 1.63; 95% confidence interval [CI], 1.06-2.51; P = .02), mean heart rate (RR, 1.03; 95% CI, 1.02-1.04; P = .0001), and heart rate range (RR, 0.990; 95% CI, 0.982-0.997; P = .008). Performance of the multivariable model was validated (area under the curve = 0.83) on a second cohort of patients. Conclusion Ambulatory electrocardiography provides useful prognostic information in patients with DCM, identifying 3 independent predictors of mortality.
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