• Yoshiyasu Aizawa, Seiji Takatsuki, Takahiko Nishiyama, Takehiro Kimura, Shun Kohsaka, Yoshiaki Kaneko, Yasuya Inden, Naohiko Takahashi, Satoshi Nagase, Yoshifusa Aizawa, and Keichi Fukuda.
• From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Y.A., S.T., T.N., T.K., S.K., K.F.); Department of Cardiovascular Medicine Gunma University Graduate School of Medicine, Japan (Y.K.); Department of Cardiology, Nagoya University Graduate School of Medicine, Japan (Y.I.); Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Japan (N.T.); Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan (S.N.); and Division of Research and Development, Tachikawa Medical Center, Niigata, Japan (Y.A.). yoshiyaaizawa-circ@umin.ac.jp.
• Circ Arrhythm Electrophysiol. 2017 Jul 1; 10 (7).

BackgroundTo know the underlying mechanisms of J waves, the response to atrial pacing was studied in patients with idiopathic ventricular fibrillation (IVF) and patients with non-IVF.Methods And ResultsIn 8 patients with IVF, the J-wave amplitude was measured before, during, and after atrial pacing. All patients had episodes of ventricular fibrillation without structural heart disease. The responses of J waves were compared with those of the 17 non-IVF control subjects who revealed J waves but no history of cardiac arrest and underwent electrophysiological study. The IVF patients were younger than the non-IVF patients (28±10 versus 52±14 years, respectively; P=0.002) and had larger J waves with more extensive distribution. J waves decreased from 0.35±0.26 to 0.22±0.23 mV (P=0.025) when the RR intervals were shortened from 782±88 to 573±162 ms (P=0.001). A decrease (≥0.05 mV) in the J-wave amplitude was observed in 6 of the 8 patients. In addition, 1 patient showed a distinct reduction of J waves in the unipolar epicardial leads. In contrast, J waves were augmented in the 17 non-IVF subjects from 0.27±0.09 to 0.38±0.10 mV (P<0.001): augmented in 9 and unchanged in the 8 subjects. The different response patterns of J waves to rapid pacing suggest different mechanisms: early repolarization in IVF patients and conduction delay in non-IVF patients.ConclusionsThe response to atrial pacing was different between the IVF and non-IVF patients, which suggests the presence of different mechanisms for the genesis of J waves.© 2017 American Heart Association, Inc.

19 keywords...

hide…