Key result
Early repolarization pattern in idiopathic VF is linked to a ~4x higher rate of appropriate ICD therapies.
Why the study?
Because data on the long-term outcome of idiopathic ventricular fibrillation were limited, this study aimed to observe ventricular arrhythmia recurrences and evaluate their correlation with ECG markers of early repolarization.
Does the presence of early repolarization pattern predict ventricular arrhythmia recurrences in patients with idiopathic ventricular fibrillation?
Cohort (n=56)
No
Does the presence of early repolarization pattern predict ventricular arrhythmia recurrences in patients with idiopathic ventricular fibrillation?
In patients with idiopathic ventricular fibrillation, the presence of an early repolarization pattern on ECG is associated with a significantly higher risk of ventricular arrhythmia recurrence.
May support closer monitoring in idiopathic VF with ERP; hypothesis-generating pending prospective validation.
BACKGROUND: Early repolarization pattern (ERP) has been associated with idiopathic ventricular fibrillation (IVF) and with cardiovascular mortality in the general population. As there is limited data about long- term outcome of IVF, the aim of our study was to observe ventricular arrhythmia (VA) recurrences in these patients and to identify a possible correlation of VA with ECG markers of early repolarization. METHODS AND RESULTS: We investigated 56 consecutive IVF patients who received an implantable cardioverter-defibrillator for secondary prevention. ERP was defined as a J-point elevation ≥ 0.1 mV in two or more contiguous inferior or lateral leads. Markers of early repolarization were present in 32.1% of cases with a preponderance of QRS slurring (77.8%). During a mean follow-up of 41.2 months, 11 patients (19.6%) received in total 18 adequate ICD-therapies. VF was most the common cause for ICDtherapy (61.1%) but monomorphic VT also occurred in four patients. Presence of ERP was associated with a significant trend towards arrhythmia recurrences. 38.9% patients with ERP received appropriate ICD-therapies whereas only 10.5% of patients without ERP had arrhythmia recurrence (p = 0.05). Inappropriate ICD-therapies occurred in seven patients (12.5%) with a non-significant trend towards a higher incidence in patients with a transvenous ICD (p = 0.15). CONCLUSION: A significant correlation between ERP and VA recurrences in patients with IVF could be observed. Though monomorphic VA also play a role in the studied IVF-population, our data support the use of the S-ICD in this collective.
No takes yet. Share an insight, caveat, or question.
Rath et al. (2022) conducted a cohort in Idiopathic ventricular fibrillation (n=56). Early repolarization pattern (ERP) vs. No early repolarization pattern was evaluated on Appropriate ICD therapies (arrhythmia recurrence) (p=0.05). The presence of early repolarization pattern in patients with idiopathic ventricular fibrillation was associated with a higher rate of appropriate ICD therapies compared to those without (38.9% vs 10.5%, p=0.05).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: