Prevalence and Characteristics of Early Repolarization in the CASPER Registry Cardiac Arrest Survivors With Preserved Ejection Fraction Registry
Prevalence and Characteristics of Early Repolarization in the CASPER Registry Cardiac Arrest Survivors With Preserved Ejection Fraction Registry
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DOI：
10.1016/j.jacc.2011.04.022
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发表时间：
2011-08-09
影响因子：
24
通讯作者：
Krahn, Andrew D.
中科院分区：
文献类型：
--
作者：
Derval, Nicolas;Simpson, Christopher S.;Krahn, Andrew D.
目的探讨心脏骤停存活者射血分数保留情况下早期复极的发生率和特点。背景：在无器质性心脏病的患者中，早期复极与多形性室性心动过速和纤颤综合征有关。方法对100例明显原因不明的心脏骤停和射血分数保留的患者进行广泛的临床和遗传学测试，以揭示亚临床的电性或结构性疾病。对12导联心电图进行盲法独立分析。早期复极定义为：-gt；=0.1 mV QRS-ST交界处(J点)抬高，并伴有至少2个相邻的下壁和/或侧壁导联QRS终末模糊或切迹。结果100例心脏骤停患者中，女性40例，年龄43+/-14岁。44人被诊断为心脏骤停的既定原因。19例患者有明显的早期复极，其中6例有心脏骤停(14%)，而56例特发性室颤(IVF)患者的这一比例为23%(p=0.23)。与有心脏骤停原因的患者相比，IVF患者的J点抬高幅度更大(0.25+/-0.11 mV比0.13+/-0.05 mV，p=0.02)，分布范围更广(4.3+/-1.3导联比2.8+/-0.8导联；p=0.01)。在连续的心电图上，J波波幅波动较大，58%的患者至少有一次心电图未能显示出早期复极。结论相当比例的病因诊断和特发性室颤患者存在早期复极。它通常是间歇性的，在试管受精患者中更明显。(不明原因心脏骤停登记；NCT00292032)。(J Am Coll心脏ol 2011；58：722-8)(C)2011，美国心脏病学会基金会
Objectives We evaluated the prevalence and characteristics of early repolarization in patients in CASPER (Cardiac Arrest Survivors With Preserved Ejection Fraction Registry).Background Early repolarization has been implicated in a syndrome of polymorphic ventricular tachycardia and fibrillation in patients without organic heart disease.Methods One hundred patients with apparently unexplained cardiac arrest and preserved ejection fraction underwent extensive clinical and genetic testing to unmask subclinical electrical or structural disease. A blinded independent analysis of the 12-lead electrocardiogram (ECG) was performed. Early repolarization was defined as >= 0.1 mV QRS-ST junction (J-point) elevation with terminal QRS slurring or notching in at least 2 contiguous inferior and/or lateral leads.Results One hundred cardiac arrest patients were enrolled (40 females, age 43 +/- 14 years). Forty-four were diagnosed with an established cause for cardiac arrest. Significant early repolarization was found in 19 patients, including 6 with a primary diagnosis that explained their cardiac arrest (14%), compared with 23% of the 56 patients with idiopathic ventricular fibrillation (IVF) (p = 0.23). J-point elevation in IVF patients had higher amplitude (0.25 +/- 0.11 mV vs. 0.13 +/- 0.05 mV, p = 0.02) and wider distribution (4.3 +/- 1.3 leads vs. 2.8 +/- 0.8 leads; p = 0.01) than those with an established cause of cardiac arrest. J-wave amplitude was fluctuant on serial ECGs; at least 1 ECG failed to demonstrate early repolarization in 58% of patients.Conclusions Early repolarization is present in a significant proportion of causally diagnosed and idiopathic VF. It is often intermittent and more pronounced in IVF patients. (Registry of Unexplained Cardiac Arrest; NCT00292032). (J Am Coll Cardiol 2011;58:722-8) (C) 2011 by the American College of Cardiology Foundation