Electrocardiographic Predictors of Mortality: Data from a Primary Care Tele-Electrocardiography Cohort of Brazilian Patients

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