Risk Stratification and Pharmacological Management in Patients with Idiopathic Ventricular Fibrillation
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概要
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Little information is available regarding risk stratification and pharmacological management in patients with idiopathic ventricular fibrillation (IVF). Our group has reported that J-wave variation is risk-stratifying factor in IVF patients. In this session, we will introduce useful noninvasive techniques and pharmacological strategies in managing IVF patients. Part 1: We enrolled 22 IVF patients and investigated the pathophysiology of J waves by assessing risk markers that reflect electrophysiological abnormalities such as late potentials (LP) using a newly developed signal-averaging system, frequency-domain heart rate variability (FD-HRV), T-wave alternans, and so on. IVF patients with J waves had a high incidence of LP associating high frequency components (vagal tone index) on FD-HRV analysis, with night ascendancy. J waves may be more closely associated with depolarization abnormality and autonomic modulation than repolarization abnormality. Part 2: We enrolled 8 young IVF patients who had real life-threatening events. In two patients with J-wave variation, pharmacological therapy including class III antiarrhythmic drugs and β-blockers are ineffective. However, β-blockers were effective in two of three patients without J waves and in two of three patients without J-wave variation on 12-lead and Holter ECGs. Any pharmacological therapy is ineffective when J-wave variation was observed, but β-blockers are occasionally effective when such a phenomenon was not seen in young IVF patients.
著者
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Ikeda Takanori
Department Of Cardiovascular Medicine Graduate School Of Medicine Kyoto University
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Miwa Yosuke
Second Department Of Internal Medicine Kyorin University School Of Medicine
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Abe Atsuko
Second Department Of Internal Medicine Kyorin University School Of Medicine
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Ikeda Takanori
Department of Cardiovascular Medicine, Toho University Medical Center Tokyo
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