| Left ventricular dysfunction is associated with prolonged average ventricular fibrillation cycle length in patients with implantable cardioverter defibrillators. | |
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MedLine Citation:
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PMID: 12510136 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: In cellular studies, ventricular refractoriness (ERP) is prolonged in heart failure (CHF), but clinical evidence is lacking. The average ventricular fibrillation cycle length (VFCL) has been shown to correlate with local ERP. We hypothesized that the VFCL increases with left ventricular (LV) dysfunction. Therefore, we evaluated intracardiac VFCL recorded by implantable defibrillators (ICD) in patients with and without LV dysfunction. METHODS: We analyzed intracardiac VFCL recorded by sensing leads of Ventak MINI (Guidant) ICD in 49 patients (35 men; age 54 +/- 13 years; 25 (51%) with coronary artery disease; mean LV ejection fraction (EF) 41 +/- 17%, range 76-10) from the European Ventak MINI Investigator Group. No patients were receiving antiarrhythmic drugs, including beta-blockers. Mean and median VFCL were obtained at predischarge testing during first charge time (4.5 +/- 2.7 s, range 1.4-11). RESULTS: Mean median VFCL was 186 +/- 21ms (range 150-230 ms). Patients with LVEF >/= 50% (n = 14) had shorter median VFCL than patients with LVEF < 50% (n = 35), (171 +/- 14 vs. 191 +/- 20 ms; p = 0.002). Median VFCL correlated with LVEF (r = -0.41; p = 0.003) and age (r = 0.28, p = 0.04), but was not significantly associated with charge time and defibrillation threshold at implant. Similar results occurred with mean VFCL. In multiple linear regression and correlation models, only LVEF% was a significant predictor (p < 0.05 for all models) of median VFCL. CONCLUSIONS: LV dysfunction prolongs averaged VFCL in patients at risk for malignant ventricular arrhythmias who have implantable cardioverter defibrillators. This phenomenon might be related to alterations in the ventricular refractory period. |
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Authors:
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Guilherme Fenelon; Bruce S Stambler; Etienne Huvelle; Pedro Brugada; William G Stevenson; |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing Volume: 7 ISSN: 1383-875X ISO Abbreviation: J Interv Card Electrophysiol Publication Date: 2002 Dec |
Date Detail:
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Created Date: 2003-01-02 Completed Date: 2003-05-22 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9708966 Medline TA: J Interv Card Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 249-54 Citation Subset: IM |
Affiliation:
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Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. guilhermefenelon@uol.com.br |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Analysis of Variance Defibrillators, Implantable* Female Humans Linear Models Male Middle Aged Ventricular Dysfunction, Left / physiopathology* Ventricular Fibrillation / physiopathology*, prevention & control |
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