Prediction of major arrhythmic events and sudden cardiac death in dilated cardiomyopathy - The Marburg Cardiomyopathy Study design and description ofbaseline clinical characteristics

The Marburg Cardiomyopathy Study (MACAS) is a prospective observational stu dy designed to determine the value of the following potential non-invasive arrhythmia risk predictors in more than 200 patients with idiopathic dilate d cardiomyopathy (IDC) over a 5-year follow-up period: New York Heart Assoc iation functional class, left ventricular end-diastolic diameter and ejecti on fraction, left bundle branch block and atrial fibrillation on EGG, QTc a nd JTc-dispersion on 12-lead EGG, abnormal time-domain analysis and spectra l turbulence analysis of the signal-averaged EGG, ventricular arrhythmias a nd heart-rate variability on 24-hour Holter ECC, baroreflex sensitivity, an d microvolt T wave alternans during exercise. This report describes the rationale of MACAS as well as the clinical charac teristics of the first 236 patients enrolled between March 1996 and October 1999. The prognostic significance of the potential arrhythmia risk predict ors in MACAS will be determined by multivariate Cox analysis at the end of 5-year follow-up. Primary endpoints are total mortality and major arrhythmi c events defined as sustained ventricular tachycardia, ventricular fibrilla tion or sudden cardiac death. The results of MACAS will have important implications for the design of fut ure studies evaluating the role of prophylactic defibrillator therapy in id iopathic dilated cardiomyopathy.