Mode and Characteristics of Arrhythmia Initiation in Idiopathic Ventricular Fibrillation A THESIS Substudy

被引：1

作者：

Belhassen, Bernard ^{[1
,2
]}

Conte, Giulio ^{[3
]}

Steinberg, Christian ^{[4
]}

Whitaker, John ^{[5
]}

Khan, Habib R. ^{[6
]}

Laredo, Mikael ^{[7
,8
]}

Doldi, Florian ^{[9
]}

Ho, Reginald ^{[10
]}

Tadros, Rafik ^{[11
,12
]}

Dinov, Boris ^{[13
]}

Chorin, Ehud ^{[2
,14
]}

Hansom, Simon ^{[15
]}

Waintraub, Xavier ^{[7
,8
]}

Eckardt, Lars ^{[9
]}

Jankelson, Lior ^{[16
]}

Peichl, Petr ^{[17
]}

Mellor, Greg ^{[18
]}

Sy, Raymond W. ^{[19
,20
]}

Rattanawong, Pattara ^{[21
,22
]}

Stojkovic, Stefan ^{[23
]}

Garber, Leonid ^{[16
]}

Suna, Gonca ^{[18
]}

Kautzner, Josef ^{[17
]}

Chan, Kim Hoe ^{[19
,20
]}

Srivathsan, Komandoor ^{[21
]}

Tedrow, Usha ^{[24
]}

Havranek, Stepan ^{[25
]}

Murgatroyd, Francis ^{[26
]}

Shauer, Ayelet ^{[1
]}

Winkel, Bo Gregers ^{[27
]}

Page, Stephen P. ^{[28
]}

Milman, Anat ^{[2
,29
]}

Lador, Adi ^{[30
]}

Ayou, Romeo ^{[31
]}

Sellal, Jean Marc ^{[32
]}

Chevalier, Philippe ^{[33
]}

Garcia-Fernandez, F. Javier ^{[34
]}

Reichlin, Tobias ^{[35
]}

Shah, Dipen ^{[36
]}

Nazer, Babak ^{[37
]}

Bermudez-Jimenez, Francisco ^{[38
]}

Nagase, Satoshi ^{[39
]}

Morita, Hiroshi ^{[40
]}

Nam, Gi-Byoung ^{[41
]}

Pappone, Carlo ^{[42
]}

Lambiase, Pier D. ^{[43
]}

Strohmer, Bernhard ^{[44
]}

Stuehlinger, Markus ^{[45
]}

Gandjbakhch, Estelle ^{[7
,8
]}

Schulze-Bahr, Eric ^{[46
]}

机构：

[1] Hadassah Med Ctr, Heart Inst, POB 12000, IL-91120 Jerusalem, Israel

[2] Tel Aviv Univ, Tel Aviv, Israel

[3] Ente Osped Cantona, Div Cardiol, Cardioctr Ticino Inst, Lugano, Switzerland

[4] Laval Univ, Inst Univ Cardiol & Pneumol Quebec, Quebec City, PQ, Canada

[5] Kings Coll London, Dept Cardiol, Sch Biomed Engn & Imaging Sci, St Thomass Hosp, London, England

[6] Western Univ, Div Cardiol, Dept Med, Sect Cardiac Electrophysiol, London, ON, Canada

[7] Grp Hosp Pitie Salpetriere, Inst Cardiol, Paris, France

[8] Sorbonne Univ, Paris, France

[9] Univ Hosp Munster, Dept Cardiol Electrophysiol 2, Munster, Germany

[10] Thomas Jefferson Univ Hosp, Dept Med, Div Cardiol, Philadelphia, PA USA

[11] Montreal Heart Inst, Cardiovasc Genet Ctr, Montreal, PQ, Canada

[12] Univ Montreal, Fac Med, Montreal, PQ, Canada

[13] Heart Ctr Univ Leipzig, Dept Electrophysiol, Leipzig, Germany

[14] Tel Aviv Sourasky Med Ctr, Dept Cardiol, Tel Aviv, Israel

[15] Univ Ottawa Heart Inst, Ottawa, ON, Canada

[16] NYU Langone Hlth, Dept Internal Med, Leon H Charney Div Cardiol, New York, NY USA

[17] IKEM, Dept Cardiol, Prague, Czech Republic

[18] Papworth Hosp NHS Fdn Trust, Dept Cardiol, Cambridge, England

[19] Royal Prince Alfred Hosp, Dept Cardiol, Sydney, NSW, Australia

[20] Univ Sydney, Fac Med & Hlth, Sydney, NSW, Australia

[21] Mayo Clin, Dept Cardiovasc Med, Phoenix, AZ USA

[22] Harvard Med Sch, Massachusetts Gen Hosp, Demoulas Ctr Cardiac Arrhythmias, Boston, MA USA

[23] Med Univ Vienna, Dept Cardiol, Univ Clin Internal Med 2, Vienna, Austria

[24] Brigham & Womens Hosp, Dept Med, Div Cardiol, Boston, MA USA

[25] Charles Univ Prague, Cardioctr, Internal Clin Cardiol & Angiol 2, Gen Fac Hosp, Prague, Czech Republic

[26] Kings Coll Hosp London, Dept Cardiol, London, England

[27] Rigshosp, Copenhagen Univ Hosp, Dept Cardiol, Copenhagen, Denmark

[28] Leeds Teaching Hosp NHS Trust, Leeds, W Yorkshire, England

[29] Shamir Med Ctr, Arrhythmia Inst, Cardiovasc Div, Beer Yaagov, Israel

[30] Houston Methodist DeBakey Heart & Vasc Ctr & Res, Houston, TX USA

[31] Skaraborgs Sjukhus, Dept Cardiol, Electrophysiol, Skovde, Sweden

[32] Univ Lorraine, CHRU Nancy, Dept Cardiol, Nancy, France

[33] Univ Lyon, Hosp Civils Lyon, Hop Cardiol Louis Pradel, Serv Rythmol,Ctr Reference Natl Troubles Rythme C, Lyon, France

[34] Hosp Univ Burgos, Unidad Arritmias, Serv Cardiol, Burgos, Spain

[35] Univ Bern, Univ Hosp Bern, Inselspital, Dept Cardiol, Bern, Switzerland

[36] Univ Hosp, Dept Cardiol, Geneva, Switzerland

[37] Univ Washington, Div Cardiol, Seattle, WA USA

[38] Hosp Univ Virgen de las Nieves, Dept Cardiol, Granada, Spain

[39] Natl Cerebral & Cardiovasc Ctr, Dept Adv Arrhythmia & Translat Med Sci, Suita, Osaka, Japan

[40] Okayama Univ, Dept Cardiovasc Med & Therapeut, Grad Sch Med Dent & Pharmaceut Sci, Okayama, Japan

[41] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Cardiol, Seoul, South Korea

[42] IRCCS Policlin San Donato, Arrhythmia & Electrophysiol Dept, Milan, Italy

[43] St Bartholomews Hosp, Cardiac Electrophysiol, London, England

[44] Paracelsus Med Univ, Univ Hosp Salzburg, Clin Internal Med 2, Salzburg, Austria

[45] Med Univ Innsbruck, Dept Internal Med Cardiol & Angiol 3, Innsbruck, Austria

[46] Univ Hosp Munster, Inst Genet Heart Dis, Munster, Germany

[47] Univ British Columbia, Div Cardiol, Ctr Cardiovasc Innovat, Vancouver, BC, Canada

[48] Shaare Zedek Med Ctr, Jesselson Integrated Heart Ctr, Jerusalem, Israel

来源：

JACC-CLINICAL ELECTROPHYSIOLOGY | 2024年 / 10卷 / 08期

关键词：

idiopathic ventricular fibrillation; long-coupled ventricular arrhythmias; pause-dependency; polymorphic ventricular tachycardia; short-coupled ventricular arrhythmias; TORSADE-DE-POINTES; LONG-QT SYNDROME; ONSET; TACHYCARDIA;

D O I：

10.1016/j.jacep.2024.03.036

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND There is limited information on the mode of arrhythmia initiation in idiopathic ventricular fibrillation (IVF). A non-pause-dependent mechanism has been suggested to be the rule. OBJECTIVES The aim of this study was to assess the mode and characteristics of initiation of polymorphic ventricular tachycardia (PVT) in patients with short or long-coupled PVT/IVF included in THESIS (THerapy Efficacy in Short or longcoupled idiopathic ventricular fibrillation: an International Survey), a multicenter study involving 287 IVF patients treated with drugs or radiofrequency ablation. METHODS We reviewed the initiation of 410 episodes of >= 1 PVT triplet in 180 patients (58.3% females; age 39.6 +/- 13.6 years) with IVF. The incidence of pause-dependency arrhythmia initiation (prolongation by >20 ms of the preceding cycle length) was assessed. RESULTS Most arrhythmias (n = 295; 72%) occurred during baseline supraventricular rhythm without ambient pre-mature ventricular complexes (PVCs), whereas 106 (25.9%) occurred during baseline rhythm including PVCs. Nine (2.2%) arrhythmias occurred during atrial/ventricular pacing and were excluded from further analysis. Mode of PVT initiation was pause-dependent in 45 (15.6%) and 64 (60.4%) of instances in the first and second settings, respectively, for a total of 109 of 401 (27.2%). More than one type of pause-dependent and/or non-pause-dependent initiation (mean: 2.6) occurred in 94.4% of patients with $4 events. Coupling intervals of initiating PVCs were <350 ms, 350-500 ms, and >500 ms in 76.6%, 20.72%, and 2.7% of arrhythmia initiations, respectively. CONCLUSIONS Pause-dependent initiation occurred in more than a quarter of arrhythmic episodes in IVF patients. PVCs having long (between 350 and 500 ms) and very long (>500 ms) coupling intervals were observed at the initiation of nearly a quarter of PVT episodes. (JACC Clin Electrophysiol 2024;10:1794-1809) (c) 2024 by the American College of Cardiology Foundation.

引用

页码：1794 / 1809

页数：16

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