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Intracardiac J-point elevation before the onset of polymorphic ventricular tachycardia and ventricular fibrillation in patients with an implantable cardioverter-defibrillator.
MedLine Citation:
PMID:  22750217     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The clinical importance of the J-point elevation on ECG is controversial. OBJECTIVE: Study intracardiac J-point amplitude before ventricular arrhythmia. METHODS: Baseline 12-lead ECGs and far-field (FF) right ventricular (RV) intracardiac ICD electrograms (EGMs) were recorded at rest in 494 patients [mean age 60.4±13.1; 360 (72.9%) men] with structural heart disease [278 (56.3%) ischemic cardiomyopathy] who received primary [463 (93.9%) patients] or secondary prevention ICD. Ten-second intracardiac FF EGMs before the onset of arrhythmia were compared with the baseline. The J-point amplitude was measured on the baseline 12-lead surface ECG and the intracardiac FF EGM. The relative J-point amplitude was calculated as the ratio of J-point amplitude to peak-to-peak R-wave. RESULTS: The paired t-test showed that the relative intracardiac J-point amplitude was significantly higher before polymorphic ventricular tachycardia (PVT)/ventricular fibrillation (VF) onset (0.28±0.08 vs. -0.19±0.39; p=0.012) than at baseline. Relative J-point amplitude differed before supraventricular tachycardia onset. In a mixed-effects logistic regression model, adjusted for multiple episodes per patient, each 10% increase in relative J-point amplitude increased the odds of having VT/VF by 13% [OR 1.13 (95% CI 1.07-1.19); P<0.0001] and increased the odds of having PVT/VF by 27% [OR 1.27 (95% CI 1.11-1.46); P=0.001]. CONCLUSION: The relative intracardiac J-point amplitude is augmented immediately before the onset of PVT/VF in patients with structural heart disease.
Authors:
Larisa G Tereshchenko; Aaron McCabe; Lichy Han; Sanjoli Sur; Timothy Huang; Joseph E Marine; Alan Cheng; David D Spragg; Sunil Sinha; Hugh Calkins; Kenneth Stein; Gordon F Tomaselli; Ronald D Berger
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-28
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-7-3     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.
Affiliation:
The Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD.
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