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European Heart Journal 1988 9(6):625-633;
Copyright © 1988 by the European Society of Cardiology.
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© 1988 The European Society of Cardiology

Predictive value of ventricular arrhythmias in resuscitated out-of-hospital cardiac arrest victims

P. N. TEMESY-ARMOS, S. VANDERBRUG MEDENDORP, S. GOLDSTEIN, J. R. LANDIS, R. F. LEIGHTON, G. RITTER, C. M. VASU, R. A. WOLFE and A. ACHESON

Division of Cardiology, Department of Medicine, Medical College of Ohio, Toledo Ohio 43699, U.S.Asup

Received 27 May 1987; revised 17 November 1987; .

Peter N. Temesy-Armos, MD, Medical College of Ohio, Department of Medicine, 3000 South Arlington, Toledo, Ohio 43614, U.S.A.

Abstract

Twenty-four hour ambulatory electrocardiograms recorded in 103 survivors of out-of-hospital cardiac arrest were analyzed to find those characteristics of the ventricular premature complex (VPC) which provide the best combination of sensitivity, specificity, and predictive accuracy for subsequent mortality. VPC characteristics were grouped as: (1) frequent (≥25 h–1), (2) bigeminal, (3) multiform, (4) early coupled, (5) pairing, (6) repetitive ≥2, (7) repetitive ≥3, (8) repetitive ≥6, (9) the combination of frequent and repetitive, or (10) complex defined as any multiform, early, bigeminal or repetitive VPC. In an average follow-up period of 43 months, 42 deaths occurred, 17 of which were classified as sudden. Each characteristic was a significant predictor for all causes of subsequent death except early coupled VPCs and repetitive VPCs > 6. None of the characteristics reached significance as predictors for sudden death. The number of repetitive VPCs when stratified to none, ≥2 and ≥3 successive VPCs correlated with mortality in an incremental fashion. The combination of frequent VPCs and repetitive VPCs provided the best combination of sensitivity, specificity and predictive accuracy for death from all causes within five years.

Key Words: Sudden death • ambulatory electrocardiogram • ventricular premature complex • ventricular fibrillation


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