Usefulness of Continuous 24-hour Ventricular Late Potential to Predict Prognosis in Patients with Heart Failure

Area of Science:

• Cardiology
• Biomedical Engineering
• Clinical Research

Background:

• Heart failure (HF) affects an estimated 50,000 patients in Japan, with left ventricular ejection fraction (LVEF) as a primary prognostic predictor.
• There is a critical need for noninvasive markers to identify high-risk patients with HF.
• Ventricular late potentials (LPs) are electrical signal abnormalities that can indicate cardiac risk.

Purpose of the Study:

• To continuously monitor ventricular late potentials (LPs) using high-resolution ambulatory monitoring in heart failure patients with non-sustained ventricular tachycardia.
• To determine the association between LP variations and patient prognosis.

Main Methods:

• Ninety hospitalized heart failure patients were divided into cardiogenic death (n=10) and non-death (n=80) groups.
• Evaluated were LVEF, LPs, coefficient of variation (CV) of filtered QRS (fQRS), and low-amplitude signal < 40 µV for the terminal QRS portion (LAS40).
• Maximum fQRS over 24 hours (Max-fQRS) was determined.

Main Results:

• Cardiogenic death occurred in 32% of patients with LVEF ≤ 45% and Max-fQRS ≤ 114 ms.
• Cardiogenic death occurred in 38% of patients with LAS40-CV ≥ 0.09.
• Using LVEF, Max-fQRS, and LAS40-CV predicted outcomes with 83% specificity and 82% accuracy (odds ratio 12.3).

Conclusions:

• Variations and increases in LAS40 may serve as novel indicators for predicting prognosis in heart failure patients.
• This study highlights the potential of LAS40 as a noninvasive risk stratification tool.
• Further research is warranted to validate LAS40 as a prognostic marker in larger cohorts.