Poor R-wave progression linked to sudden cardiac death: Study

For the study, researchers collected the data and 12-lead ECGs from a Finnish general population health examination survey conducted from 1978 to 1980 with follow-up until 2011. The main endpoints were SCD, cardiac death, and all-cause mortality. PRWP was defined as R-wave amplitude ≤ 0.3 mV in lead V3 and R-wave amplitude in lead V2 ≤ R-wave amplitude in lead V3.

Key findings from the data are,

• 213 subjects (3.1%) showed PRWP.

• PRWP was associated with SCD (HR, 2.13), cardiac death (HR, 1.75), and all-cause mortality (HR, 1.29).

• In the subgroup analysis of patients with coronary artery disease (CAD), PRWP had a stronger association with cardiac mortality, whereas no association with SCD was observed in those without CAD.

Researchers conclude that PRWP in an ECG is associated with increased mortality and a markedly elevated risk of adverse cardiac events in the general adult population after adjusting for several cardiac risk factors. The risk of SCD was observed in subjects with CAD. Further studies are needed to establish whether PRWP,  in combination with other risk markers, is useful in SCD risk stratification in specific patient populations the authors suggested.

Linda C. Schröder, Arttu Holkeri, Antti Eranti, M. Anette E. Haukilahti et al. Poor R-wave progression as a predictor of sudden cardiac death in the general population and subjects with coronary artery disease,  Heart Rhythm,2022,     https://doi.org/10.1016/j.hrthm.2022.02.010.