New Clinical and Electrocardiographic Classification in Patients with Idiopathic Ventricular Fibrillation
Article first published online: 18 APR 2013
© 2013 Wiley Periodicals, Inc.
Journal of Cardiovascular Electrophysiology
Volume 24, Issue 8, pages 902–908, August 2013
How to Cite
SEKIGUCHI, Y., AONUMA, K., TAKAGI, M., AIHARA, N., YOKOYAMA, Y., HIRAOKA, M. (2013), New Clinical and Electrocardiographic Classification in Patients with Idiopathic Ventricular Fibrillation. Journal of Cardiovascular Electrophysiology, 24: 902–908. doi: 10.1111/jce.12154
- Issue published online: 22 JUL 2013
- Article first published online: 18 APR 2013
- Accepted manuscript online: 2 APR 2013 08:31AM EST
- Manuscript Accepted: 6 MAR 2013
- Manuscript Revised: 4 MAR 2013
- Manuscript Received: 10 JAN 2013
- cardiac arrest;
- conduction disturbance;
- early repolarization;
- idiopathic ventricular fibrillation;
- J wave
A Subgroup of IVF Patients
The presence of early repolarization (ER) recently has been considered as a prognostic marker for sudden cardiac death in patients with idiopathic ventricular fibrillation (IVF), but there are certain numbers of IVF patients lacking ER. We aimed to clarify the clinical and electrocardiographic characteristics of the patients with IVF in the presence and absence of ER.
Methods and results
We studied 64 consecutive IVF patients from the Japan Idiopathic Ventricular Fibrillation Study (J-IVFS) registry, which subjected with at least one episode of documented VF in the absence of structural heart diseases and excluding Brugada syndrome. We assessed clinical and electrophysiological characteristics in the IVF patients with and without ER. ER was defined as J-point elevation of >0.1 mV in either inferior or lateral leads. Twelve-lead electrocardiogram (ECG) demonstrated 24 (38%) of 64 patients with ER (ER[+] group) and the remaining 40 (62%) patients without ER (ER[–] group ). ER[+] group had a male predominance (92% for males) and ER[–] group revealed nearly equal distribution in both sexes. While no patients in ER[+] group showed intraventricular conduction disturbance (CD) with abnormal axis deviation and/or bundle branch block in ECG, 9 in ER[–] group had signs of CD (ER[–]/CD[+] subgroup). ER[–]/CD[+] subgroup had prolonged P-R interval and QRS duration compared to other patient groups.
We found 3 distinct ECG patterns in IVF patients. In addition to the presence and absence of ER, there is a subgroup without ER demonstrating intraventricular CD, which represents a distinct clinical entity of IVF.