J-Wave Elevation in the Inferior Leads Predicts Lethal Ventricular Arrhythmia Initiated by Premature Ventricular Contractions With Right Bundle Branch Block and Superior Axis

Circulation Journal : Official Journal of the Japanese Circulation Society
Yumi MunetsuguToshiro Shinke

Abstract

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. We speculate that J-wave elevation in the ...Continue Reading

References

Mar 7, 2002·Lancet·Michel HaïssaguerreJacques Clémenty
Aug 21, 2002·Circulation·Michel HaïssaguerreJacques Clémenty
Apr 25, 2003·Pacing and Clinical Electrophysiology : PACE·Toshiharu TakeuchiNaoyuki Hasebe
Aug 26, 2003·The American Journal of Medicine·Arthur L KlatskyMary Anne Armstrong
May 9, 2008·The New England Journal of Medicine·Michel HaïssaguerreJacques Clémenty
Nov 6, 2008·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Eric GoodFrank Bogun
Feb 14, 2009·Journal of the American College of Cardiology·Michel HaïssaguerreJacques Clémenty
Mar 21, 2009·Journal of Cardiovascular Electrophysiology·Takumi YamadaG Neal Kay
Apr 1, 2008·Circulation. Arrhythmia and Electrophysiology·Harish DoppalapudiG Neal Kay
Feb 16, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Charles Antzelevitch, Gan-Xin Yan
Aug 10, 2010·The American Journal of Cardiology·Matthias WilhelmFrank Flachskampf
Jan 3, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Mikiko NakagawaTetsunori Saikawa
Aug 14, 2012·Journal of Cardiovascular Electrophysiology·Elad AnterMark E Josephson
Aug 29, 2013·Journal of Electrocardiology·Frederic SacherMichel Haïssaguerre
Jan 9, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Hugo Van HerendaelFrancis E Marchlinski
Jun 21, 2014·Journal of Cardiovascular Electrophysiology·Francesco SantoroAndrea Natale

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