Tachycardia-Induced J-Wave Changes in Patients with and Without Idiopathic Ventricular Fibrillation

Yoshiyasu Aizawa, Seiji Takatsuki, Takahiko Nishiyama, Takehiro Kimura, Shun Kohsaka, Yoshiaki Kaneko, Yasuya Inden, Naohiko Takahashi, Satoshi Nagase, Yoshifusa Aizawa, Keichi Fukuda

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Background - To know the underlying mechanisms of J waves, the response to atrial pacing was studied in patients with idiopathic ventricular fibrillation (IVF) and patients with non-IVF. Methods and Results - In 8 patients with IVF, the J-wave amplitude was measured before, during, and after atrial pacing. All patients had episodes of ventricular fibrillation without structural heart disease. The responses of J waves were compared with those of the 17 non-IVF control subjects who revealed J waves but no history of cardiac arrest and underwent electrophysiological study. The IVF patients were younger than the non-IVF patients (28±10 versus 52±14 years, respectively; P=0.002) and had larger J waves with more extensive distribution. J waves decreased from 0.35±0.26 to 0.22±0.23 mV (P=0.025) when the RR intervals were shortened from 782±88 to 573±162 ms (P=0.001). A decrease (≥0.05 mV) in the J-wave amplitude was observed in 6 of the 8 patients. In addition, 1 patient showed a distinct reduction of J waves in the unipolar epicardial leads. In contrast, J waves were augmented in the 17 non-IVF subjects from 0.27±0.09 to 0.38±0.10 mV (P<0.001): augmented in 9 and unchanged in the 8 subjects. The different response patterns of J waves to rapid pacing suggest different mechanisms: early repolarization in IVF patients and conduction delay in non-IVF patients. Conclusions - The response to atrial pacing was different between the IVF and non-IVF patients, which suggests the presence of different mechanisms for the genesis of J waves.

Original languageEnglish
Article numbere005214
JournalCirculation: Arrhythmia and Electrophysiology
Volume10
Issue number7
DOIs
Publication statusPublished - 2017 Jul 1

Keywords

  • electrocardiogram
  • ion channels
  • sudden death
  • ventricular fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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