{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T01:18:36Z","timestamp":1773623916863,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T00:00:00Z","timestamp":1616371200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["139080"],"award-info":[{"award-number":["139080"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Noninvasive Electrocardiol"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A novel metric called Layered Symbolic Decomposition frequency (LSDf) has been shown to be an independent predictor of ventricular arrhythmia and mortality in patients receiving implantable cardioverter\u2010defibrillator (ICD) devices. This novel index studies the fragmentation of the QRS complex. However, its generalizability to predict cardiovascular events for other cardiac procedures is unknown. Herein, we investigated the applicability of LSDf as a predictive measure for major adverse cardiovascular events (MACE) in patients receiving coronary artery bypass grafting (CABG).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>One hundred ninety\u2010five patients had high\u2010resolution ECG recorded prior to CABG surgery in 2012\/2013 and were followed for a mean duration of 7.32\u00a0\u00b1\u00a00.32\u00a0years for postoperative cardiovascular outcomes. These outcomes were described as a modified composite of MACE defined as hospitalization for heart failure, ventricular tachycardia, ventricular fibrillation, and cardiovascular death including stroke and cardiac arrest. One hundred seventy\u2010two patients were included for analysis and 18 patients experienced a postoperative cardiovascular outcome. These patients had significantly increased age (71.3 vs. 64.6\u00a0years, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.007), prolonged QRS duration (113.22 vs. 97.35\u00a0ms, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.003), reduced left ventricular ejection fraction (42.7% vs. 56.5%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001), and lower LSDf percent (13.5% vs. 16.9%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.002). Patients with an LSDf below 13.25% were 4.8 (OR 1.7\u201313.5, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001) times more likely to experience a MACE and up to 19.4 (OR 4.2\u201390.3, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001) times more likely to experience a MACE when older than 70\u00a0years and an ejection fraction below 50%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Layered Symbolic Decomposition frequency may be an applicable metric to predict long\u2010term cardiovascular outcomes in patients with ischemic heart disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/anec.12822","type":"journal-article","created":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T05:56:26Z","timestamp":1616478986000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Predicting adverse cardiovascular outcomes in post\u2010coronary artery bypass grafting patients using novel ECG frequency analysis of the QRS complex"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5608-4635","authenticated-orcid":false,"given":"Thalia","family":"Hua","sequence":"first","affiliation":[{"name":"Queen's University Kingston ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Vlahos","sequence":"additional","affiliation":[{"name":"Queen's University Kingston ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Hassan","family":"Shariat","sequence":"additional","affiliation":[{"name":"Queen's University Kingston ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darrin","family":"Payne","sequence":"additional","affiliation":[{"name":"Queen's University Kingston ON Canada"},{"name":"Kingston Health Sciences Centre Kingston ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damian","family":"Redfearn","sequence":"additional","affiliation":[{"name":"Queen's University Kingston ON Canada"},{"name":"Kingston Health Sciences Centre Kingston ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,3,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.06.031"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1406944"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(88)90115-4"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep35869"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.4065\/mcp.2009.0391"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/anec.12629"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050496"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(97)80001-4"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3109\/14017431.2011.651485"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.5402\/2012\/258769"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/14017430410021615"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhj.2002.122516"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(03)00886-5"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.01.071"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.4070\/kcj.2018.0115"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2007.03.045"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(99)00134-7"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.15420\/icr.2011.9.2.77"},{"key":"e_1_2_11_20_1","volume-title":"Clinical 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