Aro et al reported a score based on changes in the 12-lead ECG that may predict sudden cardiac death. This can help to identify a patient who may benefit from more aggressive management. The authors are from Cedars Sinai Medical Center, Helsinki University Hospital, University of Southern California, Oregon Health and Science University and Wake Forest University.
Patient selection: age >= 18 years
Parameters:
(1) heart rate in beats per minute
(2) left ventricular hypertrophy using the Sokolow-Lyon or Cornell criteria
(3) QRS transition zone
(4) frontal QRS-T angle
(5) QTc interval in milliseconds
(6) T-peak to T-end (Tp Te) interval in milliseconds
(7) sex
Parameter
Finding
Points
heart rate
<= 75 beats per minute
0
> 75 beats per minute
1
left venticular hypertrophy
absent
0
present
1
QRS transition zone >= V5
absent
0
present
1
frontal QRS-T angle
<= 90 degrees
0
> 90 degrees (wide)
1
QTc interval
<= 450 ms male; <= 460 ms female
0
> 450 ms male, > 460 ms female
1
Tp Te interval
<= 89 ms
0
> 89 ms
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the greater the risk for sudden cardiac death.
Score
Odds Ratio SCD
0
1
1
2
2
4
3
8.5
4 or 5
21
Performance:
• The area under the ROC curve is 0.75.
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