{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T19:24:55Z","timestamp":1777836295502,"version":"3.51.4"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Cardiomyopathy patients are at risk of sudden death, typically from scar-related abnormalities of electrical activation that promote ventricular tachyarrhythmias. Abnormal intra-QRS peaks may provide a measure of altered activation. We hypothesized that quantification of such QRS peaks (QRSp) in high-resolution ECGs would predict arrhythmic events in implantable cardioverter\u2013defibrillator (ICD)\u2013eligible cardiomyopathy patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              Ninety-nine patients with ischemic or non-ischemic dilated cardiomyopathy undergoing prophylactic ICD implantation were prospectively enrolled (age 62\u00b111 years, left ventricular ejection fraction 27\u00b17%). High-resolution (1024 Hz) digital 12-lead ECGs were recorded during intrinsic rhythm. QRSp was quantified for each precordial lead as the total number of low-amplitude deflections that deviated from their respective naive QRS template. The primary end point of arrhythmic events was defined as appropriate ICD therapy or sustained ventricular tachyarrhythmias. After a median follow-up of 24 (15\u201343) months, 20 (20%) patients had arrhythmic events. Both QRSp and QRS duration were greater in those with arrhythmic events (both\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and this was consistent for QRSp for both cardiomyopathy types. In a multivariable Cox regression model that included age, left ventricular ejection fraction, QRS duration, and QRSp, only QRSp was an independent predictor of arrhythmic events (hazard ratio, 2.1;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Receiver operating characteristic analysis revealed that a QRSp \u22652.25 identified arrhythmic events with greater sensitivity (100% versus 70%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05) and negative predictive value (100% versus 89%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05) than QRS duration \u2265120 ms.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>QRSp measured from high-resolution digital 12-lead ECGs independently predicts ventricular tachyarrhythmias in ICD-eligible cardiomyopathy patients. This novel QRS morphology index has the potential to improve sudden death risk stratification and patient selection for prophylactic ICD therapy.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.116.004874","type":"journal-article","created":{"date-parts":[[2017,7,14]],"date-time":"2017-07-14T01:10:39Z","timestamp":1499994639000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Automated Quantification of Low-Amplitude Abnormal QRS Peaks From High-Resolution ECG Recordings Predicts Arrhythmic Events in Patients With Cardiomyopathy"],"prefix":"10.1161","volume":"10","author":[{"given":"Moloy","family":"Das","sequence":"first","affiliation":[{"name":"From the Peter Munk Cardiac Center, Division of Cardiology, University Health Network, Toronto, Ontario, Canada (M.D., A.M.S., S.N., K.V., D.A.S., G.T., R.D., V.S.C.); Department of Cardiology, Freeman Hospital, Newcastle Upon Tyne, United Kingdom (M.D.); Division of Cardiology, St. Michael\u2019s Hospital, Toronto, Ontario, Canada (A.P.); Division of Cardiology, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada (E.C.); and Department of Electrical and Computer Engineering, Ryerson University,..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian M.","family":"Suszko","sequence":"additional","affiliation":[{"name":"From the Peter Munk Cardiac Center, Division of Cardiology, University Health Network, Toronto, Ontario, Canada (M.D., A.M.S., S.N., K.V., D.A.S., G.T., R.D., V.S.C.); Department of Cardiology, Freeman Hospital, Newcastle Upon Tyne, United Kingdom (M.D.); Division of Cardiology, St. Michael\u2019s Hospital, Toronto, Ontario, Canada (A.P.); Division of Cardiology, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada (E.C.); and Department of Electrical and Computer Engineering, Ryerson University,..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sachin","family":"Nayyar","sequence":"additional","affiliation":[{"name":"From the Peter Munk Cardiac Center, Division of Cardiology, University Health Network, Toronto, Ontario, Canada (M.D., A.M.S., S.N., K.V., D.A.S., G.T., R.D., V.S.C.); Department of Cardiology, Freeman Hospital, Newcastle Upon Tyne, United Kingdom (M.D.); Division of Cardiology, St. Michael\u2019s Hospital, Toronto, Ontario, Canada (A.P.); Division of Cardiology, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada (E.C.); and Department of Electrical and Computer Engineering, Ryerson University,..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karthik","family":"Viswanathan","sequence":"additional","affiliation":[{"name":"From the Peter Munk Cardiac Center, Division of Cardiology, University Health Network, Toronto, Ontario, Canada (M.D., A.M.S., S.N., K.V., D.A.S., G.T., R.D., V.S.C.); Department of Cardiology, Freeman Hospital, Newcastle Upon Tyne, United Kingdom (M.D.); Division of Cardiology, St. Michael\u2019s Hospital, Toronto, Ontario, Canada (A.P.); Division of Cardiology, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada (E.C.); and Department of Electrical and Computer Engineering, Ryerson University,..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danna A.","family":"Spears","sequence":"additional","affiliation":[{"name":"From the Peter Munk Cardiac Center, Division of Cardiology, University Health Network, Toronto, Ontario, Canada (M.D., A.M.S., S.N., K.V., D.A.S., G.T., R.D., V.S.C.); Department of Cardiology, Freeman Hospital, Newcastle Upon Tyne, United Kingdom (M.D.); Division of Cardiology, St. Michael\u2019s Hospital, Toronto, Ontario, Canada (A.P.); Division of Cardiology, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada (E.C.); and Department of Electrical and Computer Engineering, Ryerson University,..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Tomlinson","sequence":"additional","affiliation":[{"name":"From the Peter Munk Cardiac Center, Division of Cardiology, University Health Network, Toronto, Ontario, Canada (M.D., A.M.S., S.N., K.V., D.A.S., G.T., R.D., V.S.C.); Department of Cardiology, Freeman Hospital, Newcastle Upon Tyne, United Kingdom (M.D.); Division of Cardiology, St. Michael\u2019s Hospital, Toronto, Ontario, Canada (A.P.); Division of Cardiology, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada (E.C.); and Department of Electrical and Computer Engineering, Ryerson University,..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arnold","family":"Pinter","sequence":"additional","affiliation":[{"name":"From the Peter Munk Cardiac Center, Division of Cardiology, University Health Network, Toronto, Ontario, Canada (M.D., A.M.S., S.N., K.V., D.A.S., G.T., R.D., V.S.C.); Department of Cardiology, Freeman Hospital, Newcastle Upon Tyne, United Kingdom (M.D.); Division of Cardiology, St. Michael\u2019s Hospital, Toronto, Ontario, Canada (A.P.); Division of Cardiology, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada (E.C.); and Department of Electrical and Computer Engineering, Ryerson University,..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugene","family":"Crystal","sequence":"additional","affiliation":[{"name":"From the Peter Munk Cardiac Center, Division of Cardiology, University Health Network, Toronto, Ontario, Canada (M.D., A.M.S., S.N., K.V., D.A.S., G.T., R.D., V.S.C.); Department of Cardiology, Freeman Hospital, Newcastle Upon Tyne, United Kingdom (M.D.); Division of Cardiology, St. Michael\u2019s Hospital, Toronto, Ontario, Canada (A.P.); Division of Cardiology, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada (E.C.); and Department of Electrical and Computer Engineering, Ryerson University,..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rupin","family":"Dalvi","sequence":"additional","affiliation":[{"name":"From the Peter Munk Cardiac Center, Division of Cardiology, University Health Network, Toronto, Ontario, Canada (M.D., A.M.S., S.N., K.V., D.A.S., G.T., R.D., V.S.C.); Department of Cardiology, Freeman Hospital, Newcastle Upon Tyne, United Kingdom (M.D.); Division of Cardiology, St. Michael\u2019s Hospital, Toronto, Ontario, Canada (A.P.); Division of Cardiology, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada (E.C.); and Department of Electrical and Computer Engineering, Ryerson University,..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sridhar","family":"Krishnan","sequence":"additional","affiliation":[{"name":"From the Peter Munk Cardiac Center, Division of Cardiology, University Health Network, Toronto, Ontario, Canada (M.D., A.M.S., S.N., K.V., D.A.S., G.T., R.D., V.S.C.); Department of Cardiology, Freeman Hospital, Newcastle Upon Tyne, United Kingdom (M.D.); Division of Cardiology, St. Michael\u2019s Hospital, Toronto, Ontario, Canada (A.P.); Division of Cardiology, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada (E.C.); and Department of Electrical and Computer Engineering, Ryerson University,..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vijay S.","family":"Chauhan","sequence":"additional","affiliation":[{"name":"From the Peter Munk Cardiac Center, Division of Cardiology, University Health Network, Toronto, Ontario, Canada (M.D., A.M.S., S.N., K.V., D.A.S., G.T., R.D., V.S.C.); Department of Cardiology, Freeman Hospital, Newcastle Upon Tyne, United Kingdom (M.D.); Division of Cardiology, St. Michael\u2019s Hospital, Toronto, Ontario, Canada (A.P.); Division of Cardiology, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada (E.C.); and Department of Electrical and Computer Engineering, Ryerson University,..."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e318276ce9b"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv316"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013474"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/hc2901.093197"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2005.11.024"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.39.4.531"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.40.6.927"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.86.6.1888"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12226"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.108.798660"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.595892"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.107.763284"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eut014"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/anec.12065"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2010.09.071"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.110.940478"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.2459\/JCM.0b013e32834ae458"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2009.09.065"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2012.02390.x"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/anec.12141"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-474X.2010.00353.x"},{"key":"e_1_3_3_23_2","volume-title":"Paper presented at: 2015 IEEE International Conference on Electro\/Information Technology (EIT)","author":"Suszko AM","unstructured":"Suszko AM, Dalvi R, Das M, Chauhan VS. Quantifying abnormal QRS peaks using a novel time-domain peak detection algorithm: application in patients with cardiomyopathy at risk of sudden death. Paper presented at: 2015 IEEE International Conference on Electro\/Information Technology (EIT); May 21\u201323, 2015."},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004669-198407000-00002"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.770917"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/0010-4809(77)90021-0"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(90)90841-N"}],"container-title":["Circulation: Arrhythmia and Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCEP.116.004874","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T23:22:38Z","timestamp":1715556158000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCEP.116.004874"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7]]},"references-count":26,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2017,7]]}},"alternative-id":["10.1161\/CIRCEP.116.004874"],"URL":"https:\/\/doi.org\/10.1161\/circep.116.004874","relation":{},"ISSN":["1941-3149","1941-3084"],"issn-type":[{"value":"1941-3149","type":"print"},{"value":"1941-3084","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7]]},"assertion":[{"value":"2016-11-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-06-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-07-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e004874"}}