J Waves Are Associated With the Increased Occurrence of Life‐Threatening Ventricular Tachyarrhythmia in Patients With Nonischemic Cardiomyopathy. (6th October 2016)

• Record Type: Journal Article
• Authors: NARUSE, YOSHIHISA; NOGAMI, AKIHIKO; SHINODA, YASUTOSHI; HANAKI, YUICHI; SHIRAI, YASUHIRO; KOWASE, SHINYA; KUROSAKI, KENJI; MACHINO, TAKESHI; KUROKI, KENJI; YAMASAKI, HIRO; IGARASHI, MIYAKO; SEKIGUCHI, YUKIO; AONUMA, KAZUTAKA
• Is Part Of: Journal of cardiovascular electrophysiology. Volume 27:Number 12(2016)
• Page Start: 1448
• Page End: 1453
• Publication Date: 2016-10-06
• Subjects: implantable cardioverter defibrillator -- J wave -- ventricular tachyarrhythmia -- nonischemic cardiomyopathy -- repolarization; Blood vessels -- Physiology -- Periodicals; Electrophysiology -- Periodicals; Heart -- Physiology -- Periodicals; 612.1
• DOI: 10.1111/jce.13096
• Languages: English
• ISSNs: 1045-3873

Abstract

J Wave and VT/VF of Nonischemic Cardiomyopathy: Introduction: Recent studies showed that J waves were associated with higher incidence of ventricular tachyarrhythmia (VT/VF) in patients with idiopathic ventricular fibrillation (VF) and myocardial infarction. We sought to assess the association between J waves and VT/VF in patients with nonischemic cardiomyopathy (NICM). Methods and Results: We retrospectively enrolled 109 patients (79 men; mean age, 60 ± 15 years) with NICM who underwent implantable cardioverter defibrillator (ICD) implantation. The primary endpoint of this study was the occurrence of appropriate device therapy due to sustained VT/VF. The J wave was electrocardiographically defined as an elevation of the terminal portion of the QRS complex of >0.1 mV in at least 2 contiguous inferior or lateral leads. Among the 109 patients, 37 (34%) experienced an episode of appropriate device therapy during a median follow‐up period of 25.9 (IQR 11.5–54.3) months. Kaplan‐Meier curves showed that the presence of J waves on the 12‐lead ECG obtained before device implantation was associated with an increased occurrence of appropriate device therapy (P < 0.001). Multivariate Cox proportional regression analysis revealed that the presence of J waves (HR 2.95; 95% CI 1.31–6.64; P = 0.009) was an independent predictor for the occurrence of appropriate device therapy. In the subgroup analysis of the patients with dilated or hypertrophic cardiomyopathy, J wave tended to increase the occurrence of appropriate device therapy (P = 0.056 and P = 0.092, respectively). Conclusions: The presence of J waves was an independent predictor for the occurrence of appropriate device therapy in patients with NICM who underwent ICD implantation.