Saagar Mahida1, Nicolas Derval2, Frederic Sacher2, Antoine Leenhardt3, Isabel Deisenhofer4, Dominique Babuty5, Jürg Schläpfer6, Luc de Roy7, Robert Frank8, Sinikka Yli-Mayry9, Philippe Mabo10, Thomas Rostock11, Akihiko Nogami12, Jean-Luc Pasquié13, Christian de Chillou14, Josef Kautzner15, Laurence Jesel16, Philippe Maury17, Benjamin Berte2, Seigo Yamashita2, Laurent Roten2, Han S Lim2, Arnaud Denis2, Pierre Bordachar2, Philippe Ritter2, Vincent Probst18, Mélèze Hocini2, Pierre Jaïs2, Michel Haïssaguerre2. 1. Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France. Electronic address: saagar7m7@yahoo.co.uk. 2. Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France. 3. AP-HP, Hôpital Bichat, Service de Cardiologie et Centre de Référence des Maladies Cardiaques Héréditaires, INSERM, U698, Université Paris Diderot, Paris, France. 4. Deutsches Herzzentrum München, Munich, Germany. 5. Centre Hospitalier Universitaire de Tours, Tours, France. 6. Service de Cardiologie, CHUV, Lausanne, Switzerland. 7. Clinique Mont Godinne Leuven, Leuven, Belgium. 8. Groupe Hospitalier Pitié Salpêtrière, Paris, France. 9. Tampere University Hospital, Tampere, Finland. 10. Centre Hospitalier Universitaire de Rennes, Rennes, France. 11. Eppendorf Hospital, Hamburg, Germany. 12. University of Tsukuba, Tsukuba, Japan. 13. Centre Hospitalier Universitaire de Montpellier, Montpellier, France. 14. Centre Hospitalier Universitaire de Nancy, Nancy, France. 15. Institute for Clinical and Experimental Medicine, Department of Cardiology, Prague, Czech Republic. 16. Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France. 17. Centre Hospitalier Universitaire de Toulouse, Toulouse, France. 18. Centre Hospitalier Universitaire de Nantes, Nantes, France.
Abstract
BACKGROUND: The early repolarization (ER) pattern is associated with an increased risk of arrhythmogenic sudden death. However, strategies for risk stratification of patients with the ER pattern are not fully defined. OBJECTIVES: This study sought to determine the role of electrophysiology studies (EPS) in risk stratification of patients with ER syndrome. METHODS: In a multicenter study, 81 patients with ER syndrome (age 36 ± 13 years, 60 males) and aborted sudden death due to ventricular fibrillation (VF) were included. EPS were performed following the index VF episode using a standard protocol. Inducibility was defined by the provocation of sustained VF. Patients were followed up by serial implantable cardioverter-defibrillator interrogations. RESULTS: Despite a recent history of aborted sudden death, VF was inducible in only 18 of 81 (22%) patients. During follow-up of 7.0 ± 4.9 years, 6 of 18 (33%) patients with inducible VF during EPS experienced VF recurrences, whereas 21 of 63 (33%) patients who were noninducible experienced recurrent VF (p = 0.93). VF storm occurred in 3 patients from the inducible VF group and in 4 patients in the noninducible group. VF inducibility was not associated with maximum J-wave amplitude (VF inducible vs. VF noninducible; 0.23 ± 0.11 mV vs. 0.21 ± 0.11 mV; p = 0.42) or J-wave distribution (inferior, odds ratio [OR]: 0.96 [95% confidence interval (CI): 0.33 to 2.81]; p = 0.95; lateral, OR: 1.57 [95% CI: 0.35 to 7.04]; p = 0.56; inferior and lateral, OR: 0.83 [95% CI: 0.27 to 2.55]; p = 0.74), which have previously been demonstrated to predict outcome in patients with an ER pattern. CONCLUSIONS: Our findings indicate that current programmed stimulation protocols do not enhance risk stratification in ER syndrome.
BACKGROUND: The early repolarization (ER) pattern is associated with an increased risk of arrhythmogenic sudden death. However, strategies for risk stratification of patients with the ER pattern are not fully defined. OBJECTIVES: This study sought to determine the role of electrophysiology studies (EPS) in risk stratification of patients with ER syndrome. METHODS: In a multicenter study, 81 patients with ER syndrome (age 36 ± 13 years, 60 males) and aborted sudden death due to ventricular fibrillation (VF) were included. EPS were performed following the index VF episode using a standard protocol. Inducibility was defined by the provocation of sustained VF. Patients were followed up by serial implantable cardioverter-defibrillator interrogations. RESULTS: Despite a recent history of aborted sudden death, VF was inducible in only 18 of 81 (22%) patients. During follow-up of 7.0 ± 4.9 years, 6 of 18 (33%) patients with inducible VF during EPS experienced VF recurrences, whereas 21 of 63 (33%) patients who were noninducible experienced recurrent VF (p = 0.93). VF storm occurred in 3 patients from the inducible VF group and in 4 patients in the noninducible group. VF inducibility was not associated with maximum J-wave amplitude (VF inducible vs. VF noninducible; 0.23 ± 0.11 mV vs. 0.21 ± 0.11 mV; p = 0.42) or J-wave distribution (inferior, odds ratio [OR]: 0.96 [95% confidence interval (CI): 0.33 to 2.81]; p = 0.95; lateral, OR: 1.57 [95% CI: 0.35 to 7.04]; p = 0.56; inferior and lateral, OR: 0.83 [95% CI: 0.27 to 2.55]; p = 0.74), which have previously been demonstrated to predict outcome in patients with an ER pattern. CONCLUSIONS: Our findings indicate that current programmed stimulation protocols do not enhance risk stratification in ER syndrome.
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: Junjie Zhang; Mélèze Hocini; Maria Strom; Phillip S Cuculich; Daniel H Cooper; Frédéric Sacher; Michel Haïssaguerre; Yoram Rudy Journal: JACC Clin Electrophysiol Date: 2017-08
Authors: Shreyas Yakkali; Sneha Teresa Selvin; Sonu Thomas; Viktoriya Bikeyeva; Ahmed Abdullah; Aleksandra Radivojevic; Anas A Abu Jad; Anvesh Ravanavena; Chetna Ravindra; Emmanuelar O Igweonu-Nwakile; Safina Ali; Salomi Paul; Pousette Hamid Journal: Cureus Date: 2022-07-13
Authors: Giulio Conte; Maria Luce Caputo; François Regoli; Tiziano Moccetti; Pedro Brugada; Angelo Auricchio Journal: Arrhythm Electrophysiol Rev Date: 2016-08