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

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

Research output: Contribution to journalArticle

5 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

Fingerprint

Tachycardia
Ventricular Fibrillation
Paroxysmal ventricular fibrillation
Heart Arrest
Heart Diseases

Keywords

  • electrocardiogram
  • ion channels
  • sudden death
  • ventricular fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Tachycardia-Induced J-Wave Changes in Patients with and Without Idiopathic Ventricular Fibrillation. / Aizawa, Yoshiyasu; Takatsuki, Seiji; Nishiyama, Takahiko; Kimura, Takehiro; Kosaka, Shun; Kaneko, Yoshiaki; Inden, Yasuya; Takahashi, Naohiko; Nagase, Satoshi; Aizawa, Yoshifusa; Fukuda, Keiichi.

In: Circulation: Arrhythmia and Electrophysiology, Vol. 10, No. 7, e005214, 01.07.2017.

Research output: Contribution to journalArticle

Aizawa, Yoshiyasu ; Takatsuki, Seiji ; Nishiyama, Takahiko ; Kimura, Takehiro ; Kosaka, Shun ; Kaneko, Yoshiaki ; Inden, Yasuya ; Takahashi, Naohiko ; Nagase, Satoshi ; Aizawa, Yoshifusa ; Fukuda, Keiichi. / Tachycardia-Induced J-Wave Changes in Patients with and Without Idiopathic Ventricular Fibrillation. In: Circulation: Arrhythmia and Electrophysiology. 2017 ; Vol. 10, No. 7.
@article{1b38b524c860413aab3c11561462383d,
title = "Tachycardia-Induced J-Wave Changes in Patients with and Without Idiopathic Ventricular Fibrillation",
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.",
keywords = "electrocardiogram, ion channels, sudden death, ventricular fibrillation",
author = "Yoshiyasu Aizawa and Seiji Takatsuki and Takahiko Nishiyama and Takehiro Kimura and Shun Kosaka and Yoshiaki Kaneko and Yasuya Inden and Naohiko Takahashi and Satoshi Nagase and Yoshifusa Aizawa and Keiichi Fukuda",
year = "2017",
month = "7",
day = "1",
doi = "10.1161/CIRCEP.117.005214",
language = "English",
volume = "10",
journal = "Circulation: Arrhythmia and Electrophysiology",
issn = "1941-3149",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - Tachycardia-Induced J-Wave Changes in Patients with and Without Idiopathic Ventricular Fibrillation

AU - Aizawa, Yoshiyasu

AU - Takatsuki, Seiji

AU - Nishiyama, Takahiko

AU - Kimura, Takehiro

AU - Kosaka, Shun

AU - Kaneko, Yoshiaki

AU - Inden, Yasuya

AU - Takahashi, Naohiko

AU - Nagase, Satoshi

AU - Aizawa, Yoshifusa

AU - Fukuda, Keiichi

PY - 2017/7/1

Y1 - 2017/7/1

N2 - 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.

AB - 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.

KW - electrocardiogram

KW - ion channels

KW - sudden death

KW - ventricular fibrillation

UR - http://www.scopus.com/inward/record.url?scp=85024887575&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85024887575&partnerID=8YFLogxK

U2 - 10.1161/CIRCEP.117.005214

DO - 10.1161/CIRCEP.117.005214

M3 - Article

VL - 10

JO - Circulation: Arrhythmia and Electrophysiology

JF - Circulation: Arrhythmia and Electrophysiology

SN - 1941-3149

IS - 7

M1 - e005214

ER -