Document Detail

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:  MEDLINE    
BACKGROUND: The clinical importance of the J-point elevation on electrocardiogram is controversial.
OBJECTIVE: To study intracardiac J-point amplitude before ventricular arrhythmia.
METHODS: Baseline 12-lead electrocardiogram and far-field right ventricular intracardiac implantable cardioverter-defibrillator electrograms were recorded at rest in 494 patients (mean age 60.4 ± 13.1 years; 360 [72.9%] men) with structural heart disease (278 [56.3%] ischemic cardiomyopathy) who received primary (463 [93.9%] patients) or secondary prevention implantable cardioverter-defibrillator. Ten-second intracardiac far-field electrograms before the onset of arrhythmia were compared with the baseline. The J-point amplitude was measured on the baseline 12-lead surface electrocardiogram and the intracardiac far-field electrogram. 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/ventricular fibrillation (VF) onset (0.28 ± 0.08 vs -0.19 ± 0.39; P = .012) than at baseline. 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 ventricular tachycardia/VF by 13% (odds ratio 1.13 [95% confidence interval 1.07-1.19]; P < .0001) and increased the odds of having polymorphic ventricular tachycardia/VF by 27% (odds ratio 1.27 [95% confidence interval 1.11-1.46]; P = .001).
CONCLUSIONS: The relative intracardiac J-point amplitude is augmented immediately before the onset of polymorphic ventricular tachycardia/VF in patients with structural heart disease.
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; Research Support, N.I.H., Extramural     Date:  2012-06-29
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  9     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-26     Completed Date:  2013-05-27     Revised Date:  2013-10-17    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1594-602     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, 600 N Wolfe St., Baltimore, MD 21287, USA.
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MeSH Terms
Chi-Square Distribution
Defibrillators, Implantable*
Heart Conduction System / physiopathology
Linear Models
Middle Aged
Prospective Studies
Tachycardia, Ventricular / physiopathology*
Ventricular Fibrillation / physiopathology*
Grant Support
Comment In:
Heart Rhythm. 2012 Oct;9(10):1603-4   [PMID:  22842117 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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