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.
Int J Cardiol Heart Vasc
; 41: 101057, 2022 Aug.
Article
en En
| MEDLINE
| ID: mdl-35615735
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.
ADVENT-HF; AF, Atrial fibrillation; ASV (pf), Adaptive servo-ventilation (peak flow triggered); BPM, Beats per minute; CI, Confidence interval; ECG, Electrocardiogram; HF, Heart failure; HFrEF, Heart failure with reduced ejection fraction; HR, Heart rate; Heart failure; ICC, Intraclass correlation coefficient; Inter-observer reliability; Inv, Investigator; Methods; NCA, Nocturnal cardiac arrhythmias; NREM, Non-rapid eye movement; NSVT, Non-sustained ventricular tachycardia; PAC, Premature atrial complex(es); PSG, Polysomnography; PVC, Premature ventricular complex(es); Premature atrial complex; Premature ventricular complex; RCT, Randomized controlled trial; REM, Rapid eye movement; SDB, Sleep-disordered breathing; SVT, Supraventricular tachycardia; Sleep-disordered breathing; VT, Ventricular tachycardia
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Tipo de estudio:
Guideline
Idioma:
En
Revista:
Int J Cardiol Heart Vasc
Año:
2022
Tipo del documento:
Article
País de afiliación:
Canadá
Pais de publicación:
Irlanda