Tachycardia-Induced J-Wave Changes in Patients With and Without Idiopathic Ventricular Fibrillation
Tachycardia-Induced J-Wave Changes in Patients With and Without Idiopathic Ventricular Fibrillation
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DOI：
10.1161/circep.117.005214
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发表时间：
2017-07-01
影响因子：
8.4
通讯作者：
Fukuda, Keichi
中科院分区：
文献类型：
--
作者：
Aizawa, Yoshiyasu;Takatsuki, Seiji;Fukuda, Keichi
背景-为了了解J波的潜在机制，在特发性心室颤动（IVF）患者和非IVF患者中研究了心房起搏的反应。方法和结果-在8例IVF患者中，在心房起搏之前、期间和之后测量J波振幅。所有患者均有室颤发作，无结构性心脏病。将J波反应与17例非IVF对照者进行电生理检查，这些对照者显示J波，但无心脏骤停史。IVF患者比非IVF患者年轻（分别为28 +/-10岁和52 +/-14岁; P = 0.002），J波更大，分布更广泛。当RR间期从782 +/-88缩短至573 +/-162 ms（P = 0.001）时，J波从0.35 +/-0.26降至0.22 +/-0.23 mV（P = 0.025）。在8例患者中的6例中观察到J波振幅降低（= 0.05 mV）。此外，1例患者显示单极心外膜电极导线的J波明显减少。相比之下，17名非IVF受试者的J波从0.27 +/-0.09增加到0.38 +/-0.10 mV（P <0.001）：9名受试者增加，8名受试者不变。J波对快速起搏的不同反应模式表明不同的机制：IVF患者的早期复极和non-IVF patients.Conclusions传导延迟-IVF和non-IVF患者对心房起搏的反应不同，这表明J波的发生存在不同的机制。
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.