Mechanism of spontaneous initiation of ventricular fibrillation in patients with implantable defibrillators.
Introduction: To improve the mechanistic understanding of spontaneous initiation of ventricular fibrillation (VF), we characterized the patterns of premature ventricular complex (PVC) preceding spontaneous VF in primary and secondary implantable cardioverter‐defibrillator (ICD) recipients. Methods a...
| Published in: | Journal of Cardiovascular Electrophysiology Vol. 31; no. 9; pp. 2415 - 2425 |
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| Main Authors: | , , , , , , |
| Format: | research tables/charts tracings Journal Article |
| Published: |
Wiley-Blackwell
Sep2020
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=145514075&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 145514075 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Sep2020 vid: 31 iid: 9 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 145514075 145514075 145842942 145514075 10.1111/jce.14648 145514075 ppf: 2415 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Mechanism of spontaneous initiation of ventricular fibrillation in patients with implantable defibrillators. aug: au: Xie, Eric Mayer, Katarina Capps, Melissa F. Barth, Andreas S. Love, Charles J. Coronel, Ruben Ashikaga, Hiroshi affil: Cardiac Arrhythmia Service, Johns Hopkins University School of Medicine, Baltimore Maryland sug: subj: Ventricular Fibrillation Physiopathology Premature Ventricular Contractions Physiopathology Heart Conduction System Physiopathology Defibrillators, Implantable Methods Human Cross Sectional Studies Descriptive Statistics Death, Sudden, Cardiac Tachycardia, Ventricular ab: Introduction: To improve the mechanistic understanding of spontaneous initiation of ventricular fibrillation (VF), we characterized the patterns of premature ventricular complex (PVC) preceding spontaneous VF in primary and secondary implantable cardioverter‐defibrillator (ICD) recipients. Methods and Results: A single‐center, cross‐sectional analysis of 1209 patients with primary and secondary prevention ICD identified 190 patients who received ICD therapy (firing or antitachycardia pacing) for VF or monomorphic ventricular tachycardia (MMVT). Initiation was quantified by the coupling interval (CI), the cycle length immediately preceding the CI (CL(−1)), the CI corrected by CL(−1) using Fridericia's formula (CIc), and the prematurity index (PI). In both VF (n = 44; 23%) and MMVT (n = 134; 71%), the most common pattern of initiation was late‐coupled PVC, followed by the short‐long‐short pattern. The parameters such as pre‐initiation median CL, CL(−1), CI, and PI were not significantly different between VF and MMVT for any patterns. At least some events (45% of VF and 63% of MMVT) had extremely long CIs beyond the QTc cut‐off estimated from the CL(−1), suggestive of initiation by a train of multiple PVCs or nonsustained VT instead of a single PVC. Conclusion: Some spontaneous VF events in ICD recipients appear to be initiated by a train of multiple PVC or nonsustained VT rather than a single PVC. This finding indicates that patterns of a single PVC are not an important determinant of VF initiation and thus account for conflicting results in previous studies. pubtype: Academic Journal doctype: research tables/charts tracings Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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