High-frequency content within the QRS complex can predict ventricular tachyarrhythmias in hypertrophic cardiomyopathy

IF 1.7 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Arrhythmia Pub Date : 2025-07-28 DOI:10.1002/joa3.70130

Takeshi Tsutsumi MD, PhD, Jun Yokomachi MD, Takafumi Nakajima MD, Kentaro Minami MD, PhD, Nami Takano MD, PhD, Kuniaki Iwasawa MD, PhD, Gaku Oguri MD, PhD, Shigeru Toyoda MD, PhD, Toshiaki Nakajima MD, PhD

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Abstract

Introduction

Frequency analysis of the electrocardiographic QRS complex (QRS) was performed to evaluate the abnormal ventricular excitation in hypertrophic cardiomyopathy (HCM), from which we validated a risk stratification for lethal ventricular arrhythmias (L-VAs).

Methods

We selected 32 patients with HCM and 60 control subjects from a population of 520 consecutive patients with syncopal seizures in a university hospital. We measured bipolar X, Y, and Z leads and calculated the frequency power using continuous wavelet transform (CWT). We compared frequency powers, ranging from 15 to 250 Hz, between patients with HCM with and without L-VAs. ROC curve analysis was applied to evaluate the differences between groups.

Results

The frequency powers of the QRS were increased in HCM in the wide frequency ranges, except for 49–62 Hz. The sum of the frequency power from 150 to 250 Hz was significantly higher in HCM with versus without L-VAs. The area under the ROC curve was 0.83. The occurrence of L-VAs could be predicted with a sensitivity of 0.92 and a specificity of 0.56.

Conclusion

The high-frequency power hidden in the QRS may be a valuable predictor of L-VAs in patients with HCM.

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QRS复合体内的高频内容可以预测肥厚性心肌病的室性心动过速

通过心电图QRS复合体（QRS）的频率分析来评估肥厚性心肌病（HCM）患者的异常心室兴奋，从而验证致死性室性心律失常（L-VAs）的危险分层。方法从某大学医院520例连续晕厥发作患者中选择32例HCM患者和60例对照。我们测量了双极X、Y和Z引线，并使用连续小波变换（CWT）计算了频率功率。我们比较了HCM患者有和没有L-VAs的频率功率，范围从15到250 Hz。采用ROC曲线分析评价组间差异。结果除49 ~ 62 Hz外，HCM在较宽频率范围内QRS的频率功率均有所增加。在有l - va的HCM中，频率功率从150到250 Hz的总和明显高于没有l - va的HCM。ROC曲线下面积为0.83。预测L-VAs发生的敏感性为0.92，特异性为0.56。结论QRS中隐藏的高频功率可能是HCM患者L-VAs的一个有价值的预测指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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