Key result
Baseline ECG J waves linked to ~15-fold higher risk of induced VF in vasospastic angina.
Why the study?
The relationship between J-wave dynamics and arrhythmias during myocardial ischaemia in patients with vasospastic angina required investigation.
Observational (n=67)
Answers are grounded in this paper and cite their sources.
J-wave–arrhythmia links during ischaemia in vasospastic angina remain undetermined; leaves open for prospective validation.
AIMS: The aim of this study was to investigate the relationship between J-wave dynamics and arrhythmias during myocardial ischaemia in patients with vasospastic angina (VSA). METHODS AND RESULTS: Sixty-seven consecutive patients diagnosed with VSA by a provocation test for coronary spasm were grouped according to whether they had a J wave in the baseline electrocardiograms or not (VSA-JW group, n = 14; VSA-non-JW group: n = 53). We retrospectively studied the associations between J-wave and ST-segment dynamics and induced ventricular fibrillations (VFs) during coronary spasm. In the VSA-JW group, 7 of the 14 patients showed changes in J-wave morphology and/or gains in J-wave voltage, followed by VF in 4 patients. Compared with patients without VF, the four patients with VF showed similar maximal voltage in the baseline J waves but a higher voltage during induced coronary spasms (0.57 ± 0.49 vs. 0.30 ± 0.11 mV; P = 0.011). In three patients with VF, J waves progressively increased and were accompanied by the characteristic coved-type or lambda-shaped ST-segment elevations. In the VSA-non-JW group, only four patients showed new appearances of J waves during coronary spasms and another patient without a distinct J wave developed VF. Ventricular fibrillations were induced more frequently in the VSA-JW group than in the VSA-non-JW group [4/14 (29%) vs. 1/53 (2%); P = 0.012]. CONCLUSION: J-wave augmentations were caused by myocardial ischaemia during coronary spasms. The presence and augmentation of J waves, especially prominent J waves with the characteristic ST-elevation patterns, were associated with VF.
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Sato et al. (2011) conducted an observational in Vasospastic angina (VSA) (n=67). Baseline J wave on electrocardiogram (VSA-JW group) vs. No baseline J wave on electrocardiogram (VSA-non-JW group) was evaluated on Induced ventricular fibrillation (VF) during coronary spasm (p=0.012). Baseline ECG J waves in vasospastic angina patients were associated with higher rates of induced ventricular fibrillation during coronary spasm compared to no baseline J waves (29% vs 2%; P=0.012).