- 作者：Yoshifusa Aizawa ; MD鈦?/sup> ; aizaways@med.niigata-u.ac.jp ; Akinori Sato ; MD鈦?/sup> ; Hiroshi Watanabe ; MD鈦?/sup> ; Masaomi Chinushi ; MD鈦?/sup> ; Hiroshi Furushima ; MD鈦?/sup> ; Minoru Horie ; MD&dagger ; ; Yoshiaki Kaneko ; MD&Dagger ; ; Tsutomu Imaizumi ; MD§ ; ; Kimie Okubo ; MD鈭?/sup> ; Ichiro Watanabe ; MD鈭?/sup> ; Tsuyoshi Shinozaki ; MD¶ ; ; Yoshiyasu Aizawa ; MD# ; Keiichi Fukuda ; MD# ; Kunitake Joo ; MD鈦庘亷 ; Michel Haissaguerre ; MD&dagger ; &dagger ;
- 关键词：idiopathic ventricular fibrillation ; J-Wave ; pause-dependency
- 刊名：Journal of the American College of Cardiology
- 出版年：2012
- 期刊代码：201_07351097
- 类别：med
- 出版时间：29 May, 2012
- 卷：59
- 期：22
- 页码：1948-1953
- 文件大小：1167 K
Objectives
This study evaluated the pause-dependency of the J-wave to characterize this phenomenon in idiopathic ventricular fibrillation (VF).Background
The J-wave can be found in apparently healthy subjects and in patients at risk for sudden cardiac death, and risk stratification is therefore needed.
Methods
Forty patients with J-wave-associated idiopathic VF were studied for J waves with special reference concerning pause-dependent augmentation. J waves were defined as those 鈮?.1 mV above the isoelectric line and were compared with 76 non-VF patients of comparable age and sex.
Results
The J-wave was larger in patients with idiopathic VF than in the controls: 0.360 卤 0.181 mV versus 0.192 卤 0.064 mV (p = 0.0011). J waves were augmented during storms of VF (n = 9 [22.5%]), which was controlled by isoproterenol; they disappeared within weeks in 5 patients. In addition, sudden prolongation of the R-R interval was observed in 27 patients induced by benign arrhythmia, and 15 patients (55.6%) demonstrated pause-dependent augmentation (from 0.391 卤 0.126 mV to 0.549 卤 0.220 mV; p < 0.0001). In the other 12 experimental subjects and in the 76 control subjects, J waves remained unchanged. Pause-dependent augmentation of J waves was detected in 55.6%(sensitivity) but was specific (100%) in the patients with idiopathic VF with high positive (100%) and negative (86.4%) predictive values.
Conclusions
Pause-dependent augmentation of J waves was confirmed in about one-half of the patients with idiopathic VF after sudden R-R prolongation. Such dynamicity of J waves was specific to idiopathic VF and may be used for risk stratification.