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J-Wave Elevation in the Inferior Leads Predicts Lethal Ventricular Arrhythmia Initiated by Premature Ventricular Contractions With Right Bundle Branch Block and Superior Axis.
- Source :
-
Circulation journal : official journal of the Japanese Circulation Society [Circ J] 2019 Aug 23; Vol. 83 (9), pp. 1851-1859. Date of Electronic Publication: 2019 Aug 08. - Publication Year :
- 2019
-
Abstract
- Background: Lethal ventricular arrhythmia (VA) can be initiated by idiopathic premature ventricular contractions (PVCs) originating from the left ventricular (LV) inferior wall. Furthermore, J-wave elevation in the inferior leads on ECG is sometimes associated with lethal VA. However, the relationship between these PVCs and J-wave elevation in patients with lethal VA is unclear, so we investigated it in the present study.Methods and Results:We studied 32 consecutive patients who underwent radiofrequency (RF) ablation of idiopathic PVCs with right bundle branch block (RBBB) and superior axis. Thee PVCs were originating from the inferior wall of the LV. Lethal VA was defined as ventricular fibrillation (VF) or ventricular tachycardia (VT) with loss of consciousness (LOC). Among 32 patients, 3 had VF and 2 had VT with LOC. Other 27 had non-lethal VA. Baseline clinical characteristics were not significantly difference between lethal and non-lethal VA. The ratio of J-wave elevation in lethal VA was significantly higher as compared with non-lethal VA (100% vs. 11.1%, P<0.0001). Furthermore, no patients with J-wave elevation in the inferior leads had recurrence of lethal VA after RF ablation of the PVCs.<br />Conclusions: We speculate that J-wave elevation in the inferior leads might be a predictor of lethal VA initiated by PVCs with RBBB and superior axis. RF ablation of these PVCs was a useful method of treating lethal VA.
- Subjects :
- Action Potentials
Adolescent
Adult
Aged
Bundle-Branch Block complications
Bundle-Branch Block mortality
Bundle-Branch Block surgery
Catheter Ablation
Cause of Death
Female
Heart Rate
Humans
Male
Middle Aged
Predictive Value of Tests
Recurrence
Retrospective Studies
Risk Factors
Tachycardia, Ventricular diagnosis
Tachycardia, Ventricular mortality
Tachycardia, Ventricular prevention & control
Time Factors
Treatment Outcome
Ventricular Fibrillation diagnosis
Ventricular Fibrillation mortality
Ventricular Fibrillation prevention & control
Ventricular Premature Complexes complications
Ventricular Premature Complexes mortality
Ventricular Premature Complexes surgery
Young Adult
Bundle-Branch Block diagnosis
Electrocardiography
Tachycardia, Ventricular etiology
Ventricular Fibrillation etiology
Ventricular Premature Complexes diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1347-4820
- Volume :
- 83
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Circulation journal : official journal of the Japanese Circulation Society
- Publication Type :
- Academic Journal
- Accession number :
- 31391386
- Full Text :
- https://doi.org/10.1253/circj.CJ-19-0021