| Heterogeneous Response of J wave Syndromes to Beta-Adrenergic Stimulation. | |
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MedLine Citation:
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PMID: 22864265 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: JOURNAL ARTICLE Date: 2012-8-2 |
Journal Detail:
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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:
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Created Date: 2012-8-6 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101200317 Medline TA: Heart Rhythm Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012. Published by Elsevier Inc. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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