Differences in the onset mode of ventricular tachyarrhythmia between patients with J wave in anterior leads and those with J wave in inferolateral leads.
Differences in the onset mode of ventricular tachyarrhythmia between patients with J wave in anterior leads and those with J wave in inferolateral leads.
复制标题
前导联J波与下外侧导联J波患者室性快速心律失常发作方式的差异
DOI：
10.1016/j.hrthm.2016.11.027
复制
发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Kusano K
中科院分区：
文献类型：
--
作者：
Kamakura T;Wada M;Ishibashi K;Inoue YY;Miyamoto K;Okamura H;Nagase S;Noda T;Aiba T;Yasuda S;Shimizu W;Kamakura S;Kusano K
研究背景前导联（A导联）和下外侧导联（L导联）J波的病理生理机制尚不清楚。方法将35例ERS和52例1型BrS伴自发性室颤患者分为4组：ERS（A+L）（n = 15），任何A导联心电图均为非1型Brugada模式的ERS患者ERS（L）组（n = 20），仅L导联出现J波的ERS患者; BrS（A）组（n = 24），L导联无J波的BrS患者; BrS（A+L）28例，BrS伴L导联J波。结果A导联J波的ERS（A+L）、BrS（A）和BrS（A+L）3组夜间VTA的发生率较高，而B导联J波的发生率较低。（分别为63%、43%和47%）和突发性VTA（分别为67%、97%和86%），具有较长的室性早搏偶联间期（分别为388.8、397.3和385.6 ms），而ERS（L）组仅在L导联出现J波（25%，P = 0.0019; 19%，P <0.0001; 330.6ms，P= 0.0004），后者主要表现为短-长-短序列。A导联和L导联J波的潜在机制可能不同。
BackgroundThe pathophysiological mechanism of J wave in anterior leads (A-leads) and inferolateral leads (L-leads) remains unclear.ObjectiveWe investigated the onset mode and circadian distribution of ventricular tachyarrhythmia (VTA) episodes between patients with early repolarization syndrome (ERS) and Brugada syndrome (BrS).MethodsThe study enrolled 35 patients with ERS and 52 patients with type 1 BrS with spontaneous ventricular fibrillation who were divided into 4 groups: ERS(A+L) (n = 15), patients with ERS who had a non–type 1 Brugada pattern electrocardiogram in any A-leads (second to fourth intercostal spaces) in control and/or after drug provocation tests; ERS(L) (n = 20), patients with ERS with J wave only in L-leads; BrS(A) (n = 24), patients with BrS without J wave in L-leads; and BrS(A+L) (n = 28), patients with BrS with J wave in L-leads. The onset mode of 206 VTAs obtained from electrocardiograms or implantable cardioverter-defibrillators and the circadian distribution of 352 VTAs were investigated in the 4 groups.ResultsThree groups with J wave in A-leads, ERS(A+L), BrS(A), and BrS(A+L), had higher incidences of nocturnal (63%, 43%, and 47%, respectively) and sudden onset VTAs (67%, 97%, and 86%, respectively) with longer coupling intervals of premature ventricular contractions (388.8, 397.3, and 385.6 ms, respectively) than the ERS(L) group with J wave only in L-leads (25%,P= .0019; 19%,P< .0001; and 330.6 ms,P= .0004, respectively), the last of which mainly displayed VTAs with a short-long-short sequence.ConclusionThe onset mode of VTAs was different between patients with J wave in A-leads and patients with J wave in only L-leads. The underlying mechanism of J wave may differ between A-leads and L-leads.