Electrical Storm in Idiopathic Ventricular Fibrillation Is Associated With Early Repolarization
| Autor: | Kunitake Joo, Shogo Ito, Tsutomu Imaizumi, Masahiko Kurabayashi, Keiichi Fukuda, Michel Haïssaguerre, Seiji Takatsuki, Masahito Sato, Minoru Horie, Kanae Hasegawa, Yukio Hosaka, Yoshiaki Kaneko, Katsuya Ebe, Masaomi Chinushi, Yoshifusa Aizawa, Yoshiyasu Aizawa, Nobu Naiki |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Benign early repolarization animal diseases early repolarization Electrocardiography Young Adult Recurrence Internal medicine Humans Medicine In patient Idiopathic ventricular fibrillation Morning medicine.diagnostic_test business.industry Isoproterenol Follow up studies Middle Aged medicine.disease Defibrillators Implantable Electrophysiological Phenomena Treatment Outcome Anesthesia Ventricular Fibrillation Ventricular fibrillation Cardiology Female Cardiology and Cardiovascular Medicine business Anti-Arrhythmia Agents electrical storm idiopathic ventricular fibrillation Follow-Up Studies |
| Zdroj: | Journal of the American College of Cardiology. 62:1015-1019 |
| ISSN: | 0735-1097 |
| Popis: | ObjectivesThis study sought to characterize patients with idiopathic ventricular fibrillation (IVF) who develop electrical storms.BackgroundSome IVF patients develop ventricular fibrillation (VF) storms, but the characteristics of these patients are poorly known.MethodsNinety-one IVF patients (86% male) were selected after the exclusion of structural heart diseases, primary electrical diseases, and coronary spasm. Electrocardiogram features were compared between the patients with and without electrical storms. A VF storm was defined as VF occurring ≥3 times in 24 h and J waves >0.1 mV above the isoelectric line in contiguous leads.ResultsFourteen (15.4%) patients had VF storms occurring out-of-hospital at night or in the early morning. J waves were more closely associated with VF storms compared to patients without VF storms: 92.9% versus 36.4% (p < 0.0001). VF storms were controlled by intravenous isoproterenol, which attenuated the J-wave amplitude. After the subsidence of VF storms, the J waves decreased to the nondiagnostic level during the entire follow-up period. Implantable cardioverter-defibrillator therapy was administered to all patients during follow-up. Quinidine therapy was limited, but the patients on disopyramide (n = 3), bepridil (n = 1), or isoprenaline (n = 1) were free from VF recurrence, while VF recurred in 5 of the 9 patients who were not given antiarrhythmic drugs.ConclusionsThe VF storms in the IVF patients were highly associated with J waves that showed augmentation prior to the VF onset. Isoproterenol was effective in controlling VF and attenuated the J waves, which diminished to below the diagnostic level during follow-up. VF recurred in patients followed up without antiarrhythmic agents. |
| Databáze: | OpenAIRE |
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