12 research outputs found

    Sudden Cardiac Death Prediction in Arrhythmogenic Right Ventricular Cardiomyopathy: A Multinational Collaboration

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    BACKGROUND: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is associated with ventricular arrhythmias (VA) and sudden cardiac death (SCD). A model was recently developed to predict incident sustained VA in patients with ARVC. However, since this outcome may overestimate the risk for SCD, we aimed to specifically predict life-threatening VA (LTVA) as a closer surrogate for SCD. METHODS: We assembled a retrospective cohort of definite ARVC cases from 15 centers in North America and Europe. Association of 8 prespecified clinical predictors with LTVA (SCD, aborted SCD, sustained, or implantable cardioverter-defibrillator treated ventricular tachycardia >250 beats per minute) in follow-up was assessed by Cox regression with backward selection. Candidate variables included age, sex, prior sustained VA (≥30s, hemodynamically unstable, or implantable cardioverter-defibrillator treated ventricular tachycardia; or aborted SCD), syncope, 24-hour premature ventricular complexes count, the number of anterior and inferior leads with T-wave inversion, left and right ventricular ejection fraction. The resulting model was internally validated using bootstrapping. RESULTS: A total of 864 patients with definite ARVC (40±16 years; 53% male) were included. Over 5.75 years (interquartile range, 2.77-10.58) of follow-up, 93 (10.8%) patients experienced LTVA including 15 with SCD/aborted SCD (1.7%). Of the 8 prespecified clinical predictors, only 4 (younger age, male sex, premature ventricular complex count, and number of leads with T-wave inversion) were associated with LTVA. Notably, prior sustained VA did not predict subsequent LTVA (P=0.850). A model including only these 4 predictors had an optimism-corrected C-index of 0.74 (95% CI, 0.69-0.80) and calibration slope of 0.95 (95% CI, 0.94-0.98) indicating minimal over-optimism. CONCLUSIO

    A new prediction model for ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy

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    AIMS: Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVC) is characterized by ventricular arrhythmias (VAs) and sudden cardiac death (SCD). We aimed to develop a model for individualized prediction of incident VA/SCD in ARVC patients. METHODS AND RESULTS: Five hundred and twenty-eight patients with a definite diagnosis and no history of sustained VAs/SCD at baseline, aged 38.2 ± 15.5 years, 44.7% male, were enrolled from five registries in North America and Europe. Over 4.83 (interquartile range 2.44-9.33) years of follow-up, 146 (27.7%) experienced sustained VA, defined as SCD, aborted SCD, sustained ventricular tachycardia, or appropriate implantable cardioverter-defibrillator (ICD) therapy. A prediction model estimating annual VA risk was developed using Cox regression with internal validation. Eight potential predictors were pre-specified: age, sex, cardiac syncope in the prior 6 months, non-sustained ventricular tachycardia, number of premature ventricular complexes in 24 h, number of leads with T-wave inversion, and right and left ventricular ejection fractions (LVEFs). All except LVEF were retained in the final model. The model accurately distinguished patients with and without events, with an optimism-corrected C-index of 0.77 [95% confidence interval (CI) 0.73-0.81] and minimal over-optimism [calibration slope of 0.93 (95% CI 0.92-0.95)]. By decision curve analysis, the clinical benefit of the model was superior to a current consensus-based ICD placement algorithm with a 20.6% reduction of ICD placements with the same proportion of protected patients (P < 0.001). CONCLUSION: Using the largest cohort of patients with ARVC and no prior VA, a prediction model using readily available clinical parameters was devised to estimate VA risk and guide decisions regarding primary prevention ICDs (www.arvcrisk.com)

    Measurement of the isolated diphoton cross-section in pp collisions at sqrt(s) = 7 TeV with the ATLAS detector

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    The ATLAS experiment has measured the production cross-section of events with two isolated photons in the final state, in proton-proton collisions at sqrt(s) = 7 TeV. The full data set acquired in 2010 is used, corresponding to an integrated luminosity of 37 pb^-1. The background, consisting of hadronic jets and isolated electrons, is estimated with fully data-driven techniques and subtracted. The differential cross-sections, as functions of the di-photon mass, total transverse momentum and azimuthal separation, are presented and compared to the predictions of next-to-leading-order QCD.Comment: 15 pages plus author list (27 pages total), 9 figures, 2 tables, final version to appear in Physical Review

    Observation of WWWWWW Production in pppp Collisions at s\sqrt s =13  TeV with the ATLAS Detector

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    International audienceThis Letter reports the observation of WWWWWW production and a measurement of its cross section using 139 fb1^{-1} of proton-proton collision data recorded at a center-of-mass energy of 13 TeV by the ATLAS detector at the Large Hadron Collider. Events with two same-sign leptons (electrons or muons) and at least two jets, as well as events with three charged leptons, are selected. A multivariate technique is then used to discriminate between signal and background events. Events from WWWWWW production are observed with a significance of 8.0 standard deviations, where the expectation is 5.4 standard deviations. The inclusive WWWWWW production cross section is measured to be 820±100(stat)±80(syst)820 \pm 100\,\text{(stat)} \pm 80\,\text{(syst)} fb, approximately 2.6 standard deviations from the predicted cross section of 511±18511 \pm 18 fb calculated at next-to-leading-order QCD and leading-order electroweak accuracy

    Observation of WWWWWW Production in pppp Collisions at s\sqrt s =13  TeV with the ATLAS Detector

    No full text
    International audienceThis Letter reports the observation of WWWWWW production and a measurement of its cross section using 139 fb1^{-1} of proton-proton collision data recorded at a center-of-mass energy of 13 TeV by the ATLAS detector at the Large Hadron Collider. Events with two same-sign leptons (electrons or muons) and at least two jets, as well as events with three charged leptons, are selected. A multivariate technique is then used to discriminate between signal and background events. Events from WWWWWW production are observed with a significance of 8.0 standard deviations, where the expectation is 5.4 standard deviations. The inclusive WWWWWW production cross section is measured to be 820±100(stat)±80(syst)820 \pm 100\,\text{(stat)} \pm 80\,\text{(syst)} fb, approximately 2.6 standard deviations from the predicted cross section of 511±18511 \pm 18 fb calculated at next-to-leading-order QCD and leading-order electroweak accuracy

    Observation of WWWWWW Production in pppp Collisions at s\sqrt s =13  TeV with the ATLAS Detector

    No full text
    International audienceThis Letter reports the observation of WWWWWW production and a measurement of its cross section using 139 fb1^{-1} of proton-proton collision data recorded at a center-of-mass energy of 13 TeV by the ATLAS detector at the Large Hadron Collider. Events with two same-sign leptons (electrons or muons) and at least two jets, as well as events with three charged leptons, are selected. A multivariate technique is then used to discriminate between signal and background events. Events from WWWWWW production are observed with a significance of 8.0 standard deviations, where the expectation is 5.4 standard deviations. The inclusive WWWWWW production cross section is measured to be 820±100(stat)±80(syst)820 \pm 100\,\text{(stat)} \pm 80\,\text{(syst)} fb, approximately 2.6 standard deviations from the predicted cross section of 511±18511 \pm 18 fb calculated at next-to-leading-order QCD and leading-order electroweak accuracy

    Observation of WWWWWW Production in pppp Collisions at s\sqrt s =13  TeV with the ATLAS Detector

    No full text
    International audienceThis Letter reports the observation of WWWWWW production and a measurement of its cross section using 139 fb1^{-1} of proton-proton collision data recorded at a center-of-mass energy of 13 TeV by the ATLAS detector at the Large Hadron Collider. Events with two same-sign leptons (electrons or muons) and at least two jets, as well as events with three charged leptons, are selected. A multivariate technique is then used to discriminate between signal and background events. Events from WWWWWW production are observed with a significance of 8.0 standard deviations, where the expectation is 5.4 standard deviations. The inclusive WWWWWW production cross section is measured to be 820±100(stat)±80(syst)820 \pm 100\,\text{(stat)} \pm 80\,\text{(syst)} fb, approximately 2.6 standard deviations from the predicted cross section of 511±18511 \pm 18 fb calculated at next-to-leading-order QCD and leading-order electroweak accuracy

    Observation of WWWWWW Production in pppp Collisions at s\sqrt s =13  TeV with the ATLAS Detector

    No full text
    International audienceThis Letter reports the observation of WWWWWW production and a measurement of its cross section using 139 fb1^{-1} of proton-proton collision data recorded at a center-of-mass energy of 13 TeV by the ATLAS detector at the Large Hadron Collider. Events with two same-sign leptons (electrons or muons) and at least two jets, as well as events with three charged leptons, are selected. A multivariate technique is then used to discriminate between signal and background events. Events from WWWWWW production are observed with a significance of 8.0 standard deviations, where the expectation is 5.4 standard deviations. The inclusive WWWWWW production cross section is measured to be 820±100(stat)±80(syst)820 \pm 100\,\text{(stat)} \pm 80\,\text{(syst)} fb, approximately 2.6 standard deviations from the predicted cross section of 511±18511 \pm 18 fb calculated at next-to-leading-order QCD and leading-order electroweak accuracy

    Observation of WWWWWW Production in pppp Collisions at s\sqrt s =13  TeV with the ATLAS Detector

    No full text
    International audienceThis Letter reports the observation of WWWWWW production and a measurement of its cross section using 139 fb1^{-1} of proton-proton collision data recorded at a center-of-mass energy of 13 TeV by the ATLAS detector at the Large Hadron Collider. Events with two same-sign leptons (electrons or muons) and at least two jets, as well as events with three charged leptons, are selected. A multivariate technique is then used to discriminate between signal and background events. Events from WWWWWW production are observed with a significance of 8.0 standard deviations, where the expectation is 5.4 standard deviations. The inclusive WWWWWW production cross section is measured to be 820±100(stat)±80(syst)820 \pm 100\,\text{(stat)} \pm 80\,\text{(syst)} fb, approximately 2.6 standard deviations from the predicted cross section of 511±18511 \pm 18 fb calculated at next-to-leading-order QCD and leading-order electroweak accuracy
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