{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T11:13:07Z","timestamp":1762341187866,"version":"3.41.2"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,9,28]],"date-time":"2018-09-28T00:00:00Z","timestamp":1538092800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100011102","name":"Seventh Framework Programme","doi-asserted-by":"publisher","award":["HEALTH-F2-2013-602299"],"award-info":[{"award-number":["HEALTH-F2-2013-602299"]}],"id":[{"id":"10.13039\/100011102","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Noninvasive Electrocardiol"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Sudden cardiac death (SCD) results from a complex interplay of abnormalities in autonomic function, myocardial substrate and vulnerability. We studied whether a combination of noninvasive risk stratification tests reflecting these key players could improve risk stratification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients implanted with an ICD in whom 24\u2010hr holter recordings were available prior to implant were included. QRS fragmentation (fQRS) was selected as measure of myocardial substrate and a high ventricular premature beat count (VPB &gt;10\/hr) for arrhythmic vulnerability. From receiver operating characteristics analysis, detrended fluctuation analysis (DFA), turbulence slope, and deceleration capacity were selected for autonomic function. Adjusted Cox regression analysis with comparison of C\u2010statistics was performed to predict first appropriate shock (AS) and total mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 220 patients were included in the analysis with an overall follow\u2010up of 4.3\u00a0\u00b1\u00a03.1\u00a0years. A model including VPB &gt;10\/hr, inferior fQRS, and abnormal nonedited DFA was the best for prediction of AS after 1\u00a0year of follow\u2010up with a trends toward improvement of the C\u2010statistics compared to baseline (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.055). The risk increased significantly with every abnormal test (HR 1.793, 95%CI 1.255\u20132.564). A model including fQRS in any region and abnormal edited DFA was the best for prediction of mortality after 3\u00a0years of follow\u2010up with significant improvement of the C\u2010statistics (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.023). Each abnormal test was associated with a significant increase in mortality (HR 5.069, 95%CI 1.978\u201312.994).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Combining noninvasive risk stratification tests according to their physiological background can improve the risk prediction of SCD and mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/anec.12604","type":"journal-article","created":{"date-parts":[[2018,9,28]],"date-time":"2018-09-28T23:12:55Z","timestamp":1538176375000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Combining noninvasive risk stratification parameters improves the prediction of mortality and appropriate ICD shocks"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8296-920X","authenticated-orcid":false,"given":"Bert","family":"Vandenberk","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Sciences University of Leuven Leuven Belgium"},{"name":"Department of Cardiology University Hospitals Leuven Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Juhani","family":"Junttila","sequence":"additional","affiliation":[{"name":"Research Unit of Internal Medicine, Medical Research Center University Hospital and University of Oulu Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomas","family":"Robyns","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences University of Leuven Leuven Belgium"},{"name":"Department of Cardiology University Hospitals Leuven Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christophe","family":"Garweg","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences University of Leuven Leuven Belgium"},{"name":"Department of Cardiology University Hospitals Leuven Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joris","family":"Ector","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences University of Leuven Leuven Belgium"},{"name":"Department of Cardiology University Hospitals Leuven Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heikki V.","family":"Huikuri","sequence":"additional","affiliation":[{"name":"Research Unit of Internal Medicine, Medical Research Center University Hospital and University of Oulu Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rik","family":"Willems","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences University of Leuven Leuven Belgium"},{"name":"Department of Cardiology University Hospitals Leuven Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,9,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/anec.12343"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2013.05.065"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.06.030"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2009.07.013"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.08.077"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2008.04.017"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.595892"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.107.763284"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.304493"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.116.004610"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0828-282X(09)71050-5"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.08.042"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.959734"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013474"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.1991.tb02803.x"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euu279"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.104.523712"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.12891"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2017.02.131"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.102.11.1252"}],"container-title":["Annals of Noninvasive Electrocardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fanec.12604","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anec.12604","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T18:49:07Z","timestamp":1694803747000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/anec.12604"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,28]]},"references-count":20,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,1]]}},"alternative-id":["10.1111\/anec.12604"],"URL":"https:\/\/doi.org\/10.1111\/anec.12604","archive":["Portico"],"relation":{},"ISSN":["1082-720X","1542-474X"],"issn-type":[{"type":"print","value":"1082-720X"},{"type":"electronic","value":"1542-474X"}],"subject":[],"published":{"date-parts":[[2018,9,28]]},"assertion":[{"value":"2018-06-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-08-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-09-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e12604"}}