Prognostic Significance of J Wave in Patients Who Underwent Device Therapy for Ventricular Defibrillation

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概要

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• <B>Background:</B> J wave has been reported to be associated with higher incidences of life-threatening events in patients with either structural or nonstructural heart disease. The risk of J wave in patients who implanted a defibrillator with/without cardiac-resynchronization therapy device is unclear.<BR><B>Methods:</B> The relationship between J-wave appearance and defibrillator interventions was evaluated by analyzing electrograms stored in devices retrospectively with proportional hazards models.<BR><B>Results:</B> A total of 150 patients were enrolled and followed for a mean period of 38.8±25.0 months. Underlying heart diseases for device implantation were: myocardial infarction in 40; dilated cardiomyopathy in 30; hypertrophic cardiomyopathy in 16; ARVC in 3; Brugada syndrome in 22; idiopathic VF in 13; and others in 26 patients. Of these, 30 patients (20.0%) showed J wave at the time of implant. Patients with J wave had higher incidences of device intervention for VT/VF than those without (56.7% vs. 35.8%; P=0.0390). Multivariate analysys revealed that J-wave appearance and documented VT were independently associated with life-threatening events in patients with device implantation, even after the adjustment of age, gender, and left ventricular ejection fraction (HR, 2.20; 95% CI, 1.14–4.06; P=0.0193 and HR, 4.13; 95% CI, 2.15–8.46; P<0.0001, respectively).<BR><B>Conclusion:</B> J wave at the time of device implantation identifies the risk of future device interventions.

著者

• Sugimoto Yoshihisa

  Department Of Biochemistry Cancer Institute

• Horie Minoru

  Department Of Cardiac Physiology National Cardiovascular Center Research Institute

• Naiki Nobu

  Department Of Cardiology Nagahama City Hospital

• Miyamoto Akashi

  Department Of Cardiovascular And Respiratory Medicine Shiga University Of Medical Science

• Hayashi Hideki

  Department Clinical Pharmacology & Genetics, School of Pharmaceutical Sciences, University of Shizuoka

• ITO Makoto

  Department of Bioresources, Faculty of Agriculture, Ehime University

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