Electrocardiographic predictors of mortality: data from a primary care tele-electrocardiography cohort of Brazilian patients

Paixão, G. M. M., Lima, E. M., Gomes, P. R., Oliveira, D. M., Ribeiro, M. H., Nascimento, J. S., Ribeiro, A. H., Macfarlane, P. W. and Ribeiro, A. L. P. (2021) Electrocardiographic predictors of mortality: data from a primary care tele-electrocardiography cohort of Brazilian patients. Hearts, 2(4), pp. 449-458. (doi: 10.3390/hearts2040035)

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Abstract

Computerized electrocardiography (ECG) has been widely used and allows linkage to electronic medical records. The present study describes the development and clinical applications of an electronic cohort derived from a digital ECG database obtained by the Telehealth Network of Minas Gerais, Brazil, for the period 2010–2017, linked to the mortality data from the national information system, the Clinical Outcomes in Digital Electrocardiography (CODE) dataset. From 2,470,424 ECGs, 1,773,689 patients were identified. A total of 1,666,778 (94%) underwent a valid ECG recording for the period 2010 to 2017, with 1,558,421 patients over 16 years old; 40.2% were men, with a mean age of 51.7 [SD 17.6] years. During a mean follow-up of 3.7 years, the mortality rate was 3.3%. ECG abnormalities assessed were: atrial fibrillation (AF), right bundle branch block (RBBB), left bundle branch block (LBBB), atrioventricular block (AVB), and ventricular pre-excitation. Most ECG abnormalities (AF: Hazard ratio [HR] 2.10; 95% CI 2.03–2.17; RBBB: HR 1.32; 95%CI 1.27–1.36; LBBB: HR 1.69; 95% CI 1.62–1.76; first degree AVB: Relative survival [RS]: 0.76; 95% CI0.71–0.81; 2:1 AVB: RS 0.21 95% CI0.09–0.52; and RS 0.36; third degree AVB: 95% CI 0.26–0.49) were predictors of overall mortality, except for ventricular pre-excitation (HR 1.41; 95% CI 0.56–3.57) and Mobitz I AVB (RS 0.65; 95% CI 0.34–1.24). In conclusion, a large ECG database established by a telehealth network can be a useful tool for facilitating new advances in the fields of digital electrocardiography, clinical cardiology and cardiovascular epidemiology.

Item Type:Articles
Keywords:Electronic cohort, electrocardiogram, mortality, big data, telehealth.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Macfarlane, Professor Peter
Creator Roles:
Macfarlane, P. W.Writing – review and editing, Visualization
Authors: Paixão, G. M. M., Lima, E. M., Gomes, P. R., Oliveira, D. M., Ribeiro, M. H., Nascimento, J. S., Ribeiro, A. H., Macfarlane, P. W., and Ribeiro, A. L. P.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
Journal Name:Hearts
Publisher:MDPI
ISSN:2673-3846
ISSN (Online):2673-3846
Published Online:29 September 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in Hearts 2(4): 449-458
Publisher Policy:Reproduced under a Creative Commons License

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