Methodology for the nocturnal cardiac arrhythmia ancillary study of the ADVENT-HF trial in patients with heart failure with reduced ejection fraction and sleep-disordered breathing

URN to cite this document:

urn:nbn:de:bvb:355-epub-523896 Copy

DOI to cite this document:

10.5283/epub.52389 Copy

Horvath, Christian M. ; Fisser, Christoph ; Douglas Bradley, T. ; Floras, John S. ; Sossalla, Samuel ; Parati, Gianfranco ; Zeman, Florian ; Castiglioni, Paolo ; Faini, Andrea ; Rankin, Fiona ; Arzt, Michael

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Date of publication of this fulltext: 10 Jun 2022 06:39

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Details

Item type:	Article
Open Access Type:	Gold (with APC)
Höhe Gebühr (aus OpenAPC):	2475.2
Institution der Zahlung:	Regensburg U
Journal or Publication Title:	IJC Heart & Vasculature
Publisher:	Elsevier
Volume:	41
Page Range:	p. 101057
Date:	21 May 2022
Institutions:	Medicine > Lehrstuhl für Innere Medizin II Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien
Identification Number:	Value Type 10.1016/j.ijcha.2022.101057 DOI
Keywords:	Heart failure, Premature ventricular complex, Premature atrial complex, Sleep-disordered breathing, Inter-observer reliability, Methods, ADVENT-HF
Dewey Decimal Classification:	600 Technology > 610 Medical sciences Medicine
Status:	Published
Refereed:	Yes, this version has been refereed
Created at the University of Regensburg:	Yes
Item ID:	52389

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Abstract

Background Sleep disordered breathing (SDB) may trigger nocturnal cardiac arrhythmias (NCA) in patients with heart failure with reduced ejection fraction (HFrEF). The NCA ancillary study of the ADVENT-HF trial will test whether, in HFrEF-patients with SDB, peak-flow-triggered adaptive servo-ventilation (ASVpf) reduces NCA. To this end, accurate scoring of NCA from polysomnography (PSG) is ...

Abstract

Background
Sleep disordered breathing (SDB) may trigger nocturnal cardiac arrhythmias (NCA) in patients with heart failure with reduced ejection fraction (HFrEF). The NCA ancillary study of the ADVENT-HF trial will test whether, in HFrEF-patients with SDB, peak-flow-triggered adaptive servo-ventilation (ASVpf) reduces NCA. To this end, accurate scoring of NCA from polysomnography (PSG) is required.
Objective
To develop a method to detect NCA accurately from a single-lead electrocardiogram (ECG) recorded during PSG and assess inter-observer agreement for NCA detection.
Methods
Quality assurance of ECG analysis included training of the investigators, development of standardized technical quality, guideline-conforming semi-automated NCA-scoring via Holter-ECG software and implementation of an arrhythmia adjudication committee. To assess inter-observer agreement, the ECG was analysed by two independent investigators and compared for agreement on premature ventricular complexes (PVC) /h, premature atrial complexes/h (PAC) as well as for other NCA in 62 patients from two centers of the ADVENT-HF trial.
Results
The intraclass correlation coefficients for PVC/h and PAC/h were excellent: 0.99 (95%- confidence interval [CI]: 0.99–0.99) and 0.99 (95%-CI: 0.97–0.99), respectively. No clinically relevant difference in inter-observer classification of other NCA was found. The detection of non-sustained ventricular tachycardia (18% versus 19%) and atrial fibrillation (10% versus 11%) was similar between the two investigators. No sustained ventricular tachycardia was detected.
Conclusion
These findings indicate that our methods are very reliable for scoring NCAs and are adequate to apply for the entire PSG data set of the ADVENT-HF trial.

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Metadata last modified: 05 Dec 2022 13:32

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