OBJECTIVES: This study evaluated the pause-dependency of the J-wave to characterize this phenomenon in idiopathic ventricular fibrillation (VF). BACKGROUND: The J-wave can be found in apparently healthy subjects and in patients at risk for sudden cardiac death, and risk stratification is therefore needed. METHODS:Forty patients with J-wave-associated idiopathic VF were studied for J waves with special reference concerning pause-dependent augmentation. J waves were defined as those ≥0.1 mV above the isoelectric line and were compared with 76 non-VF patients of comparable age and sex. RESULTS: The J-wave was larger in patients with idiopathic VF than in the controls: 0.360 ± 0.181 mV versus 0.192 ± 0.064 mV (p = 0.0011). J waves were augmented during storms of VF (n = 9 [22.5%]), which was controlled by isoproterenol; they disappeared within weeks in 5 patients. In addition, sudden prolongation of the R-R interval was observed in 27 patients induced by benign arrhythmia, and 15 patients (55.6%) demonstrated pause-dependent augmentation (from 0.391 ± 0.126 mV to 0.549 ± 0.220 mV; p < 0.0001). In the other 12 experimental subjects and in the 76 control subjects, J waves remained unchanged. Pause-dependent augmentation of J waves was detected in 55.6% (sensitivity) but was specific (100%) in the patients with idiopathic VF with high positive (100%) and negative (86.4%) predictive values. CONCLUSIONS: Pause-dependent augmentation of J waves was confirmed in about one-half of the patients with idiopathic VF after sudden R-R prolongation. Such dynamicity of J waves was specific to idiopathic VF and may be used for risk stratification.
RCT Entities:
OBJECTIVES: This study evaluated the pause-dependency of the J-wave to characterize this phenomenon in idiopathic ventricular fibrillation (VF). BACKGROUND: The J-wave can be found in apparently healthy subjects and in patients at risk for sudden cardiac death, and risk stratification is therefore needed. METHODS: Forty patients with J-wave-associated idiopathic VF were studied for J waves with special reference concerning pause-dependent augmentation. J waves were defined as those ≥0.1 mV above the isoelectric line and were compared with 76 non-VFpatients of comparable age and sex. RESULTS: The J-wave was larger in patients with idiopathic VF than in the controls: 0.360 ± 0.181 mV versus 0.192 ± 0.064 mV (p = 0.0011). J waves were augmented during storms of VF (n = 9 [22.5%]), which was controlled by isoproterenol; they disappeared within weeks in 5 patients. In addition, sudden prolongation of the R-R interval was observed in 27 patients induced by benign arrhythmia, and 15 patients (55.6%) demonstrated pause-dependent augmentation (from 0.391 ± 0.126 mV to 0.549 ± 0.220 mV; p < 0.0001). In the other 12 experimental subjects and in the 76 control subjects, J waves remained unchanged. Pause-dependent augmentation of J waves was detected in 55.6% (sensitivity) but was specific (100%) in the patients with idiopathic VF with high positive (100%) and negative (86.4%) predictive values. CONCLUSIONS: Pause-dependent augmentation of J waves was confirmed in about one-half of the patients with idiopathic VF after sudden R-R prolongation. Such dynamicity of J waves was specific to idiopathic VF and may be used for risk stratification.
Authors: Charles Antzelevitch; Gan-Xin Yan; Michael J Ackerman; Martin Borggrefe; Domenico Corrado; Jihong Guo; Ihor Gussak; Can Hasdemir; Minoru Horie; Heikki Huikuri; Changsheng Ma; Hiroshi Morita; Gi-Byoung Nam; Frederic Sacher; Wataru Shimizu; Sami Viskin; Arthur A M Wilde Journal: Europace Date: 2017-04-01 Impact factor: 5.214
Authors: Martin K Stiles; Arthur A M Wilde; Dominic J Abrams; Michael J Ackerman; Christine M Albert; Elijah R Behr; Sumeet S Chugh; Martina C Cornel; Karen Gardner; Jodie Ingles; Cynthia A James; Jyh-Ming Jimmy Juang; Stefan Kääb; Elizabeth S Kaufman; Andrew D Krahn; Steven A Lubitz; Heather MacLeod; Carlos A Morillo; Koonlawee Nademanee; Vincent Probst; Elizabeth V Saarel; Luciana Sacilotto; Christopher Semsarian; Mary N Sheppard; Wataru Shimizu; Jonathan R Skinner; Jacob Tfelt-Hansen; Dao Wu Wang Journal: Heart Rhythm Date: 2020-10-19 Impact factor: 6.343