Sex differences in the origin of Purkinje ectopy-initiated idiopathic ventricular fibrillation
| Autor: | Estelle Gandjbakhch, Josselin Duchateau, Ghassen Cheniti, Elodie Surget, F. Daniel Ramirez, Fabrice Extramiana, Pierre Jaïs, Clémentine André, Yosuke Nakatani, Takashi Nakashima, Antoine Leenhardt, Akihiko Nogami, Philipp Krisai, Mélèze Hocini, Takamitsu Takagi, Olivier Bernus, Tsukasa Kamakura, Frederic Sacher, Françoise Hidden-Lucet, Romain Tixier, Michel Haïssaguerre, Nicolas Welte, Xavier Pillois, Remi Chauvel, Nicolas Derval, Thomas Pambrun, David Benoist |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Heart Ventricles Long QT syndrome medicine.medical_treatment Magnetic Resonance Imaging Cine Catheter ablation Coronary Angiography Risk Assessment Sudden death Purkinje Fibers Electrocardiography Electrophysiology study Sex Factors Risk Factors Physiology (medical) Internal medicine medicine Humans Medical history Circadian rhythm Sex Distribution Retrospective Studies Brugada syndrome medicine.diagnostic_test business.industry Incidence medicine.disease Ventricular Premature Complexes medicine.anatomical_structure Echocardiography Ventricle Ventricular Fibrillation Cardiology Female France Cardiology and Cardiovascular Medicine business |
| Zdroj: | Heart Rhythm. 18:1647-1654 |
| ISSN: | 1547-5271 |
| DOI: | 10.1016/j.hrthm.2021.07.007 |
| Popis: | Background Purkinje ectopics (PurkEs) are major triggers of idiopathic ventricular fibrillation (VF). Identifying clinical factors associated with specific PurkE characteristics could yield insights into the mechanisms of Purkinje-mediated arrhythmogenicity. Objective The purpose of this study was to examine the associations of clinical, environmental, and genetic factors with PurkE origin in patients with PurkE-initiated idiopathic VF. Methods Consecutive patients with PurkE-initiated idiopathic VF from 4 arrhythmia referral centers were included. We evaluated demographic characteristics, medical history, clinical circumstances associated with index VF events, and electrophysiological characteristics of PurkEs. An electrophysiology study was performed in most patients to confirm the Purkinje origin. Results Eighty-three patients were included (mean age 38 ± 14 years; 44 [53%] women), of whom 32 had a history of syncope. Forty-four patients had VF at rest. PurkEs originated from the right ventricle (RV) in 41 patients (49%), from the left ventricle (LV) in 36 (44%), and from both ventricles in 6 (7%). Seasonal and circadian distributions of VF episodes were similar according to PurkE origin. The clinical characteristics of patients with RV vs LV PurkE origins were similar, except for sex. RV PurkEs were more frequent in men than in women (76% vs 24%), whereas LV and biventricular PurkEs were more frequent in women (81% vs 19% and 83% vs 17%, respectively) (P Conclusion PurkEs triggering idiopathic VF originate dominantly from the RV in men and from the LV or both ventricles in women, adding to other sex-related arrhythmias such as Brugada syndrome or long QT syndrome. Sex-based factors influencing Purkinje arrhythmogenicity warrant investigation. |
| Databáze: | OpenAIRE |
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