Arrhythmias & electrophysiology
Dynamic electrocardiogram changes are a novel risk marker for sudden cardiac death
Authors' conclusion
Dynamic ECG remodelling improved SCD risk prediction beyond clinical factors combined with the static ECG, with successful validation in a geographically distinct population.
Study context
- Population
- Individuals who suffered sudden cardiac death (SCD) and matched controls from two prospective community-based SCD studies in Oregon and California, US
- Participants
- 231 / 234 / 203 / 203
- Comparison
- SCD cases vs matched controls
- Oregon SCD casesn = 231
- Oregon controlsn = 234reference
- California SCD casesn = 203
- California controlsn = 203reference
- Outcome
- Dynamic ECG remodelling: progression of a validated cumulative six-variable ECG electrical risk score
Methodological detailsmatched (age, sex, duration between electrocardiogram (ECGs)), discovery and validation cohorts, community-based
- Matched (age, sex, duration between ECGs)
- Discovery and validation cohorts
- Community-based
Main finding
As reported in the abstract
Electrical risk score change over time (dynamic ECG remodelling)
Oregon SCD cases
+1.06
95% CI +0.89 to +1.24
Oregon controls
−0.05
95% CI −0.21 to +0.11
P < 0.001
- Replicated in California (validation cohort): cases +0.87 (+0.7 to +1.04) vs controls −0.11 (−0.27 to 0.05)
- P < 0.001
Observational data: associations, not effects.
Further findings
SCD prediction (AUC), multivariable model adding dynamic ECG remodelling to baseline ECG, demographics, clinical risk factors (Oregon)
- AUC without dynamic ECG remodelling
- 0.770 (95% CI 0.727-0.812)
- AUC with dynamic ECG remodelling
- 0.869 (95% CI 0.837-0.902)
- Improved prediction also in California cohort
Original publication
Dynamic electrocardiogram changes are a novel risk marker for sudden cardiac death. Eur Heart J. Published 13 November 2023. doi:10.
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