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Twenty-four-hour ambulatory ECG monitoring relevancy in myotonic dystrophy type 1 follow-up: Prognostic value and heart rate variability evolution.
Ann Noninvasive Electrocardiol. 2019 01; 24(1):e12587.AN

Abstract

BACKGROUND

Patient prognosis in type 1 myotonic dystrophy (DM1) is very poor. Annual 24-hour holter ECG monitoring is recommended but its relevance is debated. Main objective was to determine whether holter ECG parameters could predict global death in DM1 patients and secondarily to assess whether they could predict cardiovascular events and sudden cardiac death, to compare DM1 patients and healthy controls, and to assess their evolution in DM1 over a 5-year period.

METHODS

This retrospective study included genetically confirmed DM1. Primary endpoint was global death. Secondary endpoints were labeled "sudden cardiac death" which was a composite of sudden cardiac death, aborted sudden cardiac death, implantable cardioverter defibrillator therapy, sustained ventricular tachycardia, atrioventricular block grade 3, pause >3 s; and "cardiovascular events" which was a composite of all-cause mortality, pacemaker or cardioverter defibrillator implantation, sustained ventricular tachycardia, supraventricular tachycardia, hospitalization for acute cardiac cause and heart failure.

RESULTS

Forty-seven patients (22 women, 40 ± 13 years old) were included. Three (7%) DM1 patients died, 9 (19%) experienced "sudden cardiac death" endpoint and 21 (45%) experienced "cardiovascular event" endpoint during mean follow-up of 95 ± 22 months. None of holter ECG parameters were discriminant to predict death or secondary endpoints. Compared to healthy controls, DM1 patients had higher SDNN and LF/HF ratio. Finally, heart rate variability parameters remained stable over a mean interval of 61 ± 15 months excepting pNN50 which decreased significantly.

CONCLUSION

Results suggest that annually-repeated holter ECG in DM1 is not useful for stratifying risk of sudden death and cardiovascular outcomes.

Authors+Show Affiliations

Department of Cardiology, CHU Poitiers, Poitiers, France.Department of Cardiology, CHU Poitiers, Poitiers, France.Department of Cardiology, CHU Poitiers, Poitiers, France.Department of Cardiology, CHU Poitiers, Poitiers, France.Department of Physical Medicine and Rehabilitation, CHU Poitiers, Poitiers, France.Department of Genetics, CHU Poitiers, Poitiers, France.Department of Cardiology, CHU Poitiers, Poitiers, France. Univ Poitiers, Poitiers, France.Department of Cardiology, CHU Poitiers, Poitiers, France. Univ Poitiers, Poitiers, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30101452

Citation

Gamet, Alexandre, et al. "Twenty-four-hour Ambulatory ECG Monitoring Relevancy in Myotonic Dystrophy Type 1 Follow-up: Prognostic Value and Heart Rate Variability Evolution." Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, vol. 24, no. 1, 2019, pp. e12587.
Gamet A, Degand B, Le Gal F, et al. Twenty-four-hour ambulatory ECG monitoring relevancy in myotonic dystrophy type 1 follow-up: Prognostic value and heart rate variability evolution. Ann Noninvasive Electrocardiol. 2019;24(1):e12587.
Gamet, A., Degand, B., Le Gal, F., Bidegain, N., Delaubier, A., Gilbert-Dussardier, B., Christiaens, L., & Garcia, R. (2019). Twenty-four-hour ambulatory ECG monitoring relevancy in myotonic dystrophy type 1 follow-up: Prognostic value and heart rate variability evolution. Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, 24(1), e12587. https://doi.org/10.1111/anec.12587
Gamet A, et al. Twenty-four-hour Ambulatory ECG Monitoring Relevancy in Myotonic Dystrophy Type 1 Follow-up: Prognostic Value and Heart Rate Variability Evolution. Ann Noninvasive Electrocardiol. 2019;24(1):e12587. PubMed PMID: 30101452.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Twenty-four-hour ambulatory ECG monitoring relevancy in myotonic dystrophy type 1 follow-up: Prognostic value and heart rate variability evolution. AU - Gamet,Alexandre, AU - Degand,Bruno, AU - Le Gal,François, AU - Bidegain,Nicolas, AU - Delaubier,Anne, AU - Gilbert-Dussardier,Brigitte, AU - Christiaens,Luc, AU - Garcia,Rodrigue, Y1 - 2018/08/12/ PY - 2018/04/09/received PY - 2018/06/18/revised PY - 2018/07/24/accepted PY - 2018/8/14/pubmed PY - 2018/8/14/medline PY - 2018/8/14/entrez KW - Holter monitoring KW - ambulatory electrocardiography KW - autonomic nervous system KW - heart rate variability KW - myopathy KW - type 1 myotonic dystrophy SP - e12587 EP - e12587 JF - Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc JO - Ann Noninvasive Electrocardiol VL - 24 IS - 1 N2 - BACKGROUND: Patient prognosis in type 1 myotonic dystrophy (DM1) is very poor. Annual 24-hour holter ECG monitoring is recommended but its relevance is debated. Main objective was to determine whether holter ECG parameters could predict global death in DM1 patients and secondarily to assess whether they could predict cardiovascular events and sudden cardiac death, to compare DM1 patients and healthy controls, and to assess their evolution in DM1 over a 5-year period. METHODS: This retrospective study included genetically confirmed DM1. Primary endpoint was global death. Secondary endpoints were labeled "sudden cardiac death" which was a composite of sudden cardiac death, aborted sudden cardiac death, implantable cardioverter defibrillator therapy, sustained ventricular tachycardia, atrioventricular block grade 3, pause >3 s; and "cardiovascular events" which was a composite of all-cause mortality, pacemaker or cardioverter defibrillator implantation, sustained ventricular tachycardia, supraventricular tachycardia, hospitalization for acute cardiac cause and heart failure. RESULTS: Forty-seven patients (22 women, 40 ± 13 years old) were included. Three (7%) DM1 patients died, 9 (19%) experienced "sudden cardiac death" endpoint and 21 (45%) experienced "cardiovascular event" endpoint during mean follow-up of 95 ± 22 months. None of holter ECG parameters were discriminant to predict death or secondary endpoints. Compared to healthy controls, DM1 patients had higher SDNN and LF/HF ratio. Finally, heart rate variability parameters remained stable over a mean interval of 61 ± 15 months excepting pNN50 which decreased significantly. CONCLUSION: Results suggest that annually-repeated holter ECG in DM1 is not useful for stratifying risk of sudden death and cardiovascular outcomes. SN - 1542-474X UR - https://www.unboundmedicine.com/medline/citation/30101452/Twenty_four_hour_ambulatory_ECG_monitoring_relevancy_in_myotonic_dystrophy_type_1_follow_up:_Prognostic_value_and_heart_rate_variability_evolution_ L2 - https://doi.org/10.1111/anec.12587 DB - PRIME DP - Unbound Medicine ER -
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