eprintid: 10082335
rev_number: 18
eprint_status: archive
userid: 608
dir: disk0/10/08/23/35
datestamp: 2019-09-26 09:07:54
lastmod: 2021-11-30 23:03:28
status_changed: 2019-09-26 09:07:54
type: article
metadata_visibility: show
creators_name: Cadrin-Tourigny, J
creators_name: Bosman, LP
creators_name: Nozza, A
creators_name: Wang, W
creators_name: Tadros, R
creators_name: Bhonsale, A
creators_name: Bourfiss, M
creators_name: Fortier, A
creators_name: Lie, ØH
creators_name: Saguner, AM
creators_name: Svensson, A
creators_name: Andorin, A
creators_name: Tichnell, C
creators_name: Murray, B
creators_name: Zeppenfeld, K
creators_name: van den Berg, MP
creators_name: Asselbergs, FW
creators_name: Wilde, AAM
creators_name: Krahn, AD
creators_name: Talajic, M
creators_name: Rivard, L
creators_name: Chelko, S
creators_name: Zimmerman, SL
creators_name: Kamel, IR
creators_name: Crosson, JE
creators_name: Judge, DP
creators_name: Yap, S-C
creators_name: van der Heijden, JF
creators_name: Tandri, H
creators_name: Jongbloed, JDH
creators_name: Guertin, M-C
creators_name: van Tintelen, JP
creators_name: Platonov, PG
creators_name: Duru, F
creators_name: Haugaa, KH
creators_name: Khairy, P
creators_name: Hauer, RNW
creators_name: Calkins, H
creators_name: Te Riele, ASJM
creators_name: James, CA
title: A new prediction model for ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy
ispublished: pub
divisions: UCL
divisions: B02
divisions: DD4
keywords: Arrhythmogenic right ventricular cardiomyopathy, Implantable cardioverter-defibrillators, Sudden cardiac death, Ventricular arrhythmias
note: This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/),
which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited
abstract: Aims
Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVC) is characterized by ventricular arrhythmias (VAs) and sudden cardiac death (SCD). We aimed to develop a model for individualized prediction of incident VA/SCD in ARVC patients.

Methods and results
Five hundred and twenty-eight patients with a definite diagnosis and no history of sustained VAs/SCD at baseline, aged 38.2 ± 15.5 years, 44.7% male, were enrolled from five registries in North America and Europe. Over 4.83 (interquartile range 2.44–9.33) years of follow-up, 146 (27.7%) experienced sustained VA, defined as SCD, aborted SCD, sustained ventricular tachycardia, or appropriate implantable cardioverter-defibrillator (ICD) therapy. A prediction model estimating annual VA risk was developed using Cox regression with internal validation. Eight potential predictors were pre-specified: age, sex, cardiac syncope in the prior 6 months, non-sustained ventricular tachycardia, number of premature ventricular complexes in 24 h, number of leads with T-wave inversion, and right and left ventricular ejection fractions (LVEFs). All except LVEF were retained in the final model. The model accurately distinguished patients with and without events, with an optimism-corrected C-index of 0.77 [95% confidence interval (CI) 0.73–0.81] and minimal over-optimism [calibration slope of 0.93 (95% CI 0.92–0.95)]. By decision curve analysis, the clinical benefit of the model was superior to a current consensus-based ICD placement algorithm with a 20.6% reduction of ICD placements with the same proportion of protected patients (P < 0.001).

Conclusion
Using the largest cohort of patients with ARVC and no prior VA, a prediction model using readily available clinical parameters was devised to estimate VA risk and guide decisions regarding primary prevention ICDs
date: 2019-06-14
date_type: published
official_url: https://doi.org/10.1093/eurheartj/ehz103
oa_status: green
full_text_type: pub
pmcid: PMC6568197
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1673895
doi: 10.1093/eurheartj/ehz103
pii: 5419784
lyricists_name: Asselbergs, Folkert
lyricists_id: FASSE08
actors_name: Kalinowski, Damian
actors_id: DKALI47
actors_role: owner
full_text_status: public
publication: European Heart Journal
volume: 40
number: 23
pagerange: 1850-1858
event_location: England
issn: 1522-9645
citation:        Cadrin-Tourigny, J;    Bosman, LP;    Nozza, A;    Wang, W;    Tadros, R;    Bhonsale, A;    Bourfiss, M;                                                                                                                                     ... James, CA; + view all <#>        Cadrin-Tourigny, J;  Bosman, LP;  Nozza, A;  Wang, W;  Tadros, R;  Bhonsale, A;  Bourfiss, M;  Fortier, A;  Lie, ØH;  Saguner, AM;  Svensson, A;  Andorin, A;  Tichnell, C;  Murray, B;  Zeppenfeld, K;  van den Berg, MP;  Asselbergs, FW;  Wilde, AAM;  Krahn, AD;  Talajic, M;  Rivard, L;  Chelko, S;  Zimmerman, SL;  Kamel, IR;  Crosson, JE;  Judge, DP;  Yap, S-C;  van der Heijden, JF;  Tandri, H;  Jongbloed, JDH;  Guertin, M-C;  van Tintelen, JP;  Platonov, PG;  Duru, F;  Haugaa, KH;  Khairy, P;  Hauer, RNW;  Calkins, H;  Te Riele, ASJM;  James, CA;   - view fewer <#>    (2019)    A new prediction model for ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy.                   European Heart Journal , 40  (23)   pp. 1850-1858.    10.1093/eurheartj/ehz103 <https://doi.org/10.1093/eurheartj%2Fehz103>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10082335/1/Asselbergs_A%20new%20prediction%20model%20for%20ventricular%20arrhythmias%20in%20arrhythmogenic%20right%20ventricular%20cardiomyopathy_VoR.pdf