DOI: 10.1101/19009175Oct 18, 2019Paper

Eligibility for Subcutaneous Implantable Cardioverter Defibrillator in Congenital Heart Disease

MedRxiv : the Preprint Server for Health Sciences
L. WangLarisa G Tereshchenko

Abstract

Background: The goals of this study were: assess left-and right-sided subcutaneous implantable cardioverter-defibrillator (SICD) eligibility in adult congenital heart disease (ACHD) patients, use machine learning to predict SICD eligibility in ACHD patients, and transform 12-lead ECG to S-ICD 3-lead ECG, and vice versa. Methods: ACHD outpatients (n=101; age 42{+/-}14 y; 52% female; 85% white; left ventricular ejection fraction (LVEF) 56{+/-}9%) were enrolled in a prospective study. Supine and standing 12-lead ECG was recorded simultaneously with a right- and left-sided S-ICD 3-lead ECG. Peak-to-peak QRS and T amplitudes, RR, PR, QT, QTc, QRS intervals, Tmax, and R/Tmax (31 predictor variables) were tested. Model selection, training, and testing were performed using supine ECG datasets. Validation was performed using standing ECG datasets and out-of-sample non-ACHD population (n=68; age 54{+/-}16 y; 54% female; 94% white; LVEF 61{+/-}8%). Results: A 40% of participants were ineligible for S-ICD. Tetralogy of Fallot patients passed right-sided screening (57%) more often than left-sided (21%; McNemar's {chi}2 P=0.025). The ridge model demonstrated the best cross-validation function. Validation of the ridge models was satisfactory ...Continue Reading

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