Yoshiyasu Aizawa1, Masahito Sato2, Seiko Ohno3, Minoru Horie3, Seiji Takatsuki4, Keiichi Fukuda4, Masaomi Chinushi5, Tatsuya Usui6, Kazutaka Aonuma7, Yukio Hosaka8, Michel Haissaguerre9, Yoshifusa Aizawa2. 1. Department of Cardiology, Keio University School of Medicine, Tokyo, Japan. Electronic address: yoshiyaaizawa-circ@umin.ac.jp. 2. Department of Cardiology, Tachikawa General Hospital, Niigata, Japan. 3. Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Shiga, Japan. 4. Department of Cardiology, Keio University School of Medicine, Tokyo, Japan. 5. Graduate School of Health Sciences, Niigata University School of Medicine, Niigata, Japan. 6. Department of Cardiology, Nagano Red Cross Hospital, Nagano, Japan. 7. Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan. 8. Department of Cardiology, Niigata City Hospital, Niigata, Japan. 9. HôpitalCardiologique du Haut-Lévêque, Bordeaux-Pessac, France.
Abstract
BACKGROUND: The circadian pattern of ventricular fibrillation (VF) episodes in patients with idiopathic ventricular fibrillation (IVF) is poorly understood. OBJECTIVE: The purpose of this study was to assess the circadian pattern of VF occurrence in patients with IVF. METHODS: Excluding Brugada syndrome and other primary electrical diseases, the circadian pattern of VF occurrence was determined in 64 patients with IVF. The clinical and electrocardiographic characteristics were compared among patients with nocturnal (midnight to 6:00 AM) VF and nonnocturnal VF in relation to J waves. A J wave was defined as either notching or a slur at the QRS terminal >0.1 mV above the isoelectric line in contiguous leads. RESULTS: The overall distribution pattern of VF occurrence showed 2 peaks at approximately 6:00 AM and around 8:00 PM. Nocturnal VF was observed in 20 patients (31.3%), and J waves were present in 14 of these 20 individuals (70.0%), whereas J waves were less frequent in the 44 nonnocturnal patients with VF: 16 (36.4%) (P = .0117). Among patients with J waves, nocturnal VF was observed in 46.7% with a peak at approximately 4:00 AM. Nocturnal VF was less common in patients without J waves, occurring in only 17.6% (P = .0124). Both the type and location of J waves and the pattern of the ST segment were similar between the nocturnal and nonnocturnal VF groups. J waves were associated with a VF storm and long-term arrhythmia recurrence. CONCLUSION: In IVF, the presence of J waves may characterize a higher nocturnal incidence of VF and a higher acute and chronic risk of recurrence.
BACKGROUND: The circadian pattern of ventricular fibrillation (VF) episodes in patients with idiopathic ventricular fibrillation (IVF) is poorly understood. OBJECTIVE: The purpose of this study was to assess the circadian pattern of VF occurrence in patients with IVF. METHODS: Excluding Brugada syndrome and other primary electrical diseases, the circadian pattern of VF occurrence was determined in 64 patients with IVF. The clinical and electrocardiographic characteristics were compared among patients with nocturnal (midnight to 6:00 AM) VF and nonnocturnal VF in relation to J waves. A J wave was defined as either notching or a slur at the QRS terminal >0.1 mV above the isoelectric line in contiguous leads. RESULTS: The overall distribution pattern of VF occurrence showed 2 peaks at approximately 6:00 AM and around 8:00 PM. Nocturnal VF was observed in 20 patients (31.3%), and J waves were present in 14 of these 20 individuals (70.0%), whereas J waves were less frequent in the 44 nonnocturnal patients with VF: 16 (36.4%) (P = .0117). Among patients with J waves, nocturnal VF was observed in 46.7% with a peak at approximately 4:00 AM. Nocturnal VF was less common in patients without J waves, occurring in only 17.6% (P = .0124). Both the type and location of J waves and the pattern of the ST segment were similar between the nocturnal and nonnocturnal VF groups. J waves were associated with a VF storm and long-term arrhythmia recurrence. CONCLUSION: In IVF, the presence of J waves may characterize a higher nocturnal incidence of VF and a higher acute and chronic risk of recurrence.
Authors: Samuel Chauveau; Alexandre Janin; Marianne Till; Elodie Morel; Philippe Chevalier; Gilles Millat Journal: HeartRhythm Case Rep Date: 2017-10-20