Judith L Bonnes1, Jos Thannhauser2, Mathilde C Hermans2, Sjoerd W Westra2, Thom F Oostendorp3, Gjerrit Meinsma4, Menko Jan de Boer2, Marc A Brouwer2, Joep L R M Smeets2. 1. Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: judithbonnes@gmail.com. 2. Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands. 3. Department of Cognitive Neuroscience, Donders Center for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands. 4. Faculty of Electrical Engineering, Mathematics and Computer Sciences, Department of Applied Mathematics, University of Twente, Enschede, The Netherlands.
Abstract
BACKGROUND: Characteristics of the ventricular fibrillation (VF) waveform reflect arrest duration and have been incorporated in studies on algorithms to guide resuscitative interventions. Findings in animals indicate that VF characteristics are also affected by the presence of a previous myocardial infarction (MI). As studies in humans are scarce, we assessed the impact of a previous MI on VF characteristics in ICD-patients. METHODS: Prospective cohort of ICD-patients (n=190) with defibrillation testing at the Radboudumc (2010-2013). VF characteristics of the 12-lead surface ECG were compared between three groups: patients without a history of MI (n=88), with a previous anterior (n=47) and a previous inferior MI (n=55). RESULTS: As compared to each of the other groups, the mean amplitude and amplitude spectrum area were lower, for an anterior MI in lead V3 and for an inferior MI in leads II and aVF. Across the three groups, the bandwidth was broader in the leads corresponding with the infarct localisation. In contrast, the dominant and median frequencies only differed between previous anterior MI and no history of MI, being lower in the former. CONCLUSIONS: The VF waveform is affected by the presence of a previous MI. Amplitude-related measures were lower and VF was less organised in the ECG-lead(s) adjacent to the area of infarction. Although VF characteristics of the surface ECG have so far primarily been considered a proxy for arrest duration and metabolic state, our findings question this paradigm and may provide additional insights into the future potential of VF-guided resuscitative interventions.
BACKGROUND: Characteristics of the ventricular fibrillation (VF) waveform reflect arrest duration and have been incorporated in studies on algorithms to guide resuscitative interventions. Findings in animals indicate that VF characteristics are also affected by the presence of a previous myocardial infarction (MI). As studies in humans are scarce, we assessed the impact of a previous MI on VF characteristics in ICD-patients. METHODS: Prospective cohort of ICD-patients (n=190) with defibrillation testing at the Radboudumc (2010-2013). VF characteristics of the 12-lead surface ECG were compared between three groups: patients without a history of MI (n=88), with a previous anterior (n=47) and a previous inferior MI (n=55). RESULTS: As compared to each of the other groups, the mean amplitude and amplitude spectrum area were lower, for an anterior MI in lead V3 and for an inferior MI in leads II and aVF. Across the three groups, the bandwidth was broader in the leads corresponding with the infarct localisation. In contrast, the dominant and median frequencies only differed between previous anterior MI and no history of MI, being lower in the former. CONCLUSIONS: The VF waveform is affected by the presence of a previous MI. Amplitude-related measures were lower and VF was less organised in the ECG-lead(s) adjacent to the area of infarction. Although VF characteristics of the surface ECG have so far primarily been considered a proxy for arrest duration and metabolic state, our findings question this paradigm and may provide additional insights into the future potential of VF-guided resuscitative interventions.
Authors: Michiel Hulleman; David D Salcido; James J Menegazzi; Patrick C Souverein; Hanno L Tan; Marieke T Blom; Rudolph W Koster Journal: Resuscitation Date: 2017-08-24 Impact factor: 5.262
Authors: Dieter Bender; Ryan W Morgan; Vinay M Nadkarni; Robert A Berg; Bingqing Zhang; Todd J Kilbaugh; Robert M Sutton; C Nataraj Journal: Resusc Plus Date: 2020-12-14
Authors: Jos Thannhauser; Joris Nas; Dennis J Rebergen; Sjoerd W Westra; Joep L R M Smeets; Niels Van Royen; Judith L Bonnes; Marc A Brouwer Journal: J Am Heart Assoc Date: 2020-10-02 Impact factor: 5.501