Intracardiac J-point elevation before the onset of polymorphic ventricular tachycardia and ventricular fibrillation in patients with an implantable cardioverter-defibrillator.
Intracardiac J-point elevation before the onset of polymorphic ventricular tachycardia and ventricular fibrillation in patients with an implantable cardioverter-defibrillator.
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DOI：
10.1016/j.hrthm.2012.06.036
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发表时间：
2012-10
期刊：
影响因子：
5.5
通讯作者：
Berger, Ronald D.
中科院分区：
文献类型：
--
作者：
Tereshchenko, Larisa G.;McCabe, Aaron;Han, Lichy;Sur, Sanjoli;Huang, Timothy;Marine, Joseph E.;Cheng, Alan;Spragg, David D.;Sinha, Sunil;Calkins, Hugh;Stein, Kenneth;Tomaselli, Gordon F.;Berger, Ronald D.
关键词：
J点抬高对心电图的临床重要性是有争议的。研究室性心律失常前心内J点波幅。对494例[平均年龄(60.4±13.1)岁；360例(72.9%)男性]结构性心脏病患者[278例(56.3%)缺血性心肌病患者]在静息状态下记录了12导联心电图和远场(FF)右室(RV)心内直视心电图(EGM)，并对463例(93.9%)患者进行了初步预防。将心律失常发作前10秒心内FFEGM与基线进行比较。在基线12导联体表心电图和心内FFEGM上测量J点波幅。计算相对J点波幅为J点波幅与R波峰峰值的比值。配对t检验显示，多形性室性心动过速/室颤发作前心内J点相对波幅较基线显著升高(0.28±0.08vs.−0.19±0.39；P=0.012)。在调整了每个患者多次发作的混合效应Logistic回归模型中，相对J点波幅每增加10%，发生室速/室颤的几率增加13%[OR1.13(95%CI1.07-1.19)；P<；0.0001]，发生室颤/室颤的几率增加27%[OR1.27(95%CI1.11-1.46)；P=0.001]。结构性心脏病患者在PVT/VF发作前，心内J点相对幅度增大。
The clinical importance of the J-point elevation on ECG is controversial. Study intracardiac J-point amplitude before ventricular arrhythmia. Baseline 12-lead ECGs and far-field (FF) right ventricular (RV) intracardiac ICD electrograms (EGMs) were recorded at rest in 494 patients [mean age 60.4±13.1; 360 (72.9%) men] with structural heart disease [278 (56.3%) ischemic cardiomyopathy] who received primary [463 (93.9%) patients] or secondary prevention ICD. Ten-second intracardiac FF EGMs before the onset of arrhythmia were compared with the baseline. The J-point amplitude was measured on the baseline 12-lead surface ECG and the intracardiac FF EGM. The relative J-point amplitude was calculated as the ratio of J-point amplitude to peak-to-peak R-wave. The paired t-test showed that the relative intracardiac J-point amplitude was significantly higher before polymorphic ventricular tachycardia (PVT)/ventricular fibrillation (VF) onset (0.28±0.08 vs. −0.19±0.39; p=0.012) than at baseline. In a mixed-effects logistic regression model, adjusted for multiple episodes per patient, each 10% increase in relative J-point amplitude increased the odds of having VT/VF by 13% [OR 1.13 (95% CI 1.07–1.19); P<0.0001] and increased the odds of having PVT/VF by 27% [OR 1.27 (95% CI 1.11–1.46); P=0.001]. The relative intracardiac J-point amplitude is augmented immediately before the onset of PVT/VF in patients with structural heart disease.
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影响因子：
5.5
作者：
Tereshchenko, Larisa G.;Han, Lichy;Cheng, Alan;Marine, Joseph E.;Spragg, David D.;Sinha, Sunil;Dalal, Darshan;Calkins, Hugh;Tomaselli, Gordon F.;Berger, Ronald D.
通讯作者：
Berger, Ronald D.
影响因子：
5.5
作者：
Shinohara, Tetsuji;Takahashi, Naohiko;Yoshimatsu, Hironobu
通讯作者：
Yoshimatsu, Hironobu
影响因子：
1.9
作者：
Rabe-Hesketh, S.;Skrondal, A.;Gjessing, H. K.
通讯作者：
Gjessing, H. K.
影响因子：
24
作者：
Fischell, Tim A.;Fischell, David R.;Gibson, C. Michael
通讯作者：
Gibson, C. Michael
影响因子：
4.6
作者：
Requena-Carrion, Jesus;Vaisanen, Juho;Luis Rojo-Alvarez, Jose
通讯作者：
Luis Rojo-Alvarez, Jose