Document Detail

Heterogeneous Response of J wave Syndromes to Beta-Adrenergic Stimulation.
MedLine Citation:
PMID:  22864265     Owner:  NLM     Status:  Publisher    
BACKGROUND: Inferolateral early repolarization (ER) and Brugada syndrome manifest with J waves. Isoproterenol suppresses recurrent ventricular arrhythmias while reducing J waves in both disorders. OBJECTIVE: To characterize the effect of isoproterenol on J waves. METHODS: We analyzed the impact of isoproterenol on J waves in 20 patients with Brugada type ECG (Br group) and 38 patients with ER (ER group). RESULTS: In ER group, J waves were present in inferior leads in 32 patients (84%) and lateral leads in 23 patients (61%). Isoproterenol increased heart rate by 75 bpm in ER group and 71 bpm in Br group (p=0.20). The incidences of persistent (≤0.05 mV decrease), decreased and normalized J waves (residual J wave ≤0.05 mV) were 20%, 80% and 0% for Br group patients and 29%, 8% and 63% for ER group patients, respectively (p<0.001). Within ER group, inferior J waves persisted in 34% of cases, decreased in 9% and normalized in 56% whereas lateral J waves always normalized (p<0.001). Baseline QRS width was broader in ER group patients with persistent J waves (90 ms vs. 80 ms; p=0.003) and was unchanged with isoproterenol (90 ms; p=0.19), whereas it decreased in the remaining patients (75 ms; p<0.001). CONCLUSION: J wave syndromes have distinct regional sensitivity to beta-adrenergic stimulation. J waves may persist in a subset of patients with precordial and inferior J waves but never in lateral location. This heterogeneous response to isoproterenol may indicate distinctive mechanisms for Brugada and ER patterns, including depolarization abnormalities or ion channel sensitivity.
Laurent Roten; Nicolas Derval; Frédéric Sacher; Patrizio Pascale; Daniel Scherr; Yuki Komatsu; Khaled Ramoul; Matthew Daly; Arnaud Denis; Ashok J Shah; Mélèze Hocini; Pierre Jaïs; Michel Haïssaguerre
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-2
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Inc.
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