Early repolarization of surface ECG predicts fatal ventricular arrhythmias in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy and symptomatic ventricular arrhythmias

Chao Shun Chan, Yenn Jiang Lin, Shih Lin Chang, Li Wei Lo, Yu Feng Hu, Tze Fan Chao, Fa Po Chung, Jo Nan Liao, Yi Jen Chen, Shih Ann Chen

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Abstract Background The clinical characteristics and prognostic value of early repolarization (ER) in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) and symptomatic ventricular arrhythmias remain unclear. We investigated the prevalence, clinical features, and cardiovascular outcomes of patients with symptomatic ARVD/C and ER. Methods A total of 59 consecutive ARVD/C patients hospitalized for catheter ablation, presenting with and without J-point elevations of ≥ 0.1 mV in at least 2 inferior leads or lateral leads were enrolled. Clinical characteristics, electrophysiological study, substrate mapping, catheter ablation, and future clinical outcomes in a prospective patient registry were investigated. Results ER was observed in 38 patients (64.4%). Among these patients, ER was found in the inferior leads in 18 patients (47.4%), in the lateral leads in 2 patients (5.3%), and in both inferior and lateral leads in 18 patients (47.4%). Patients exhibiting ER were commonly men, had lower right ventricular ejection fraction, had higher incidence of clinical ventricular fibrillation or aborted sudden cardiac death, had more defibrillator implantations, had higher the need of epicardial ablation, and had more major criteria according to the task force criteria. Significant higher incidence of induced ventricular fibrillation and shorter tachycardia cycle length of induced ventricular tachycardia were found during procedure. The recurrence rate of ventricular arrhythmias did not differ between patients with and without ER after catheter ablation. Conclusions A high prevalence of electrocardiographic ER was found among symptomatic ARVD/C patients undergoing catheter ablation. ER in 12-lead ECG is associated with an increased risk of clinical fatal ventricular arrhythmias.

Original languageEnglish
Article number20663
Pages (from-to)300-305
Number of pages6
JournalInternational Journal of Cardiology
Volume197
DOIs
Publication statusPublished - Aug 5 2015

Fingerprint

Arrhythmogenic Right Ventricular Dysplasia
Cardiac Arrhythmias
Electrocardiography
Catheter Ablation
Ventricular Fibrillation
Defibrillators
Sudden Cardiac Death
Incidence
Advisory Committees
Ventricular Tachycardia
Tachycardia
Stroke Volume
Registries

Keywords

  • Arrhythmogenic right ventriculardysplasia/cardiomyopathy
  • Catheter ablation
  • Early repolarization
  • Ventricular arrhythmia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Early repolarization of surface ECG predicts fatal ventricular arrhythmias in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy and symptomatic ventricular arrhythmias. / Chan, Chao Shun; Lin, Yenn Jiang; Chang, Shih Lin; Lo, Li Wei; Hu, Yu Feng; Chao, Tze Fan; Chung, Fa Po; Liao, Jo Nan; Chen, Yi Jen; Chen, Shih Ann.

In: International Journal of Cardiology, Vol. 197, 20663, 05.08.2015, p. 300-305.

Research output: Contribution to journalArticle

Chan, Chao Shun ; Lin, Yenn Jiang ; Chang, Shih Lin ; Lo, Li Wei ; Hu, Yu Feng ; Chao, Tze Fan ; Chung, Fa Po ; Liao, Jo Nan ; Chen, Yi Jen ; Chen, Shih Ann. / Early repolarization of surface ECG predicts fatal ventricular arrhythmias in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy and symptomatic ventricular arrhythmias. In: International Journal of Cardiology. 2015 ; Vol. 197. pp. 300-305.
@article{85caa414853c42e8b7a1e046fbf410dd,
title = "Early repolarization of surface ECG predicts fatal ventricular arrhythmias in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy and symptomatic ventricular arrhythmias",
abstract = "Abstract Background The clinical characteristics and prognostic value of early repolarization (ER) in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) and symptomatic ventricular arrhythmias remain unclear. We investigated the prevalence, clinical features, and cardiovascular outcomes of patients with symptomatic ARVD/C and ER. Methods A total of 59 consecutive ARVD/C patients hospitalized for catheter ablation, presenting with and without J-point elevations of ≥ 0.1 mV in at least 2 inferior leads or lateral leads were enrolled. Clinical characteristics, electrophysiological study, substrate mapping, catheter ablation, and future clinical outcomes in a prospective patient registry were investigated. Results ER was observed in 38 patients (64.4{\%}). Among these patients, ER was found in the inferior leads in 18 patients (47.4{\%}), in the lateral leads in 2 patients (5.3{\%}), and in both inferior and lateral leads in 18 patients (47.4{\%}). Patients exhibiting ER were commonly men, had lower right ventricular ejection fraction, had higher incidence of clinical ventricular fibrillation or aborted sudden cardiac death, had more defibrillator implantations, had higher the need of epicardial ablation, and had more major criteria according to the task force criteria. Significant higher incidence of induced ventricular fibrillation and shorter tachycardia cycle length of induced ventricular tachycardia were found during procedure. The recurrence rate of ventricular arrhythmias did not differ between patients with and without ER after catheter ablation. Conclusions A high prevalence of electrocardiographic ER was found among symptomatic ARVD/C patients undergoing catheter ablation. ER in 12-lead ECG is associated with an increased risk of clinical fatal ventricular arrhythmias.",
keywords = "Arrhythmogenic right ventriculardysplasia/cardiomyopathy, Catheter ablation, Early repolarization, Ventricular arrhythmia",
author = "Chan, {Chao Shun} and Lin, {Yenn Jiang} and Chang, {Shih Lin} and Lo, {Li Wei} and Hu, {Yu Feng} and Chao, {Tze Fan} and Chung, {Fa Po} and Liao, {Jo Nan} and Chen, {Yi Jen} and Chen, {Shih Ann}",
year = "2015",
month = "8",
day = "5",
doi = "10.1016/j.ijcard.2015.06.007",
language = "English",
volume = "197",
pages = "300--305",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Early repolarization of surface ECG predicts fatal ventricular arrhythmias in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy and symptomatic ventricular arrhythmias

AU - Chan, Chao Shun

AU - Lin, Yenn Jiang

AU - Chang, Shih Lin

AU - Lo, Li Wei

AU - Hu, Yu Feng

AU - Chao, Tze Fan

AU - Chung, Fa Po

AU - Liao, Jo Nan

AU - Chen, Yi Jen

AU - Chen, Shih Ann

PY - 2015/8/5

Y1 - 2015/8/5

N2 - Abstract Background The clinical characteristics and prognostic value of early repolarization (ER) in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) and symptomatic ventricular arrhythmias remain unclear. We investigated the prevalence, clinical features, and cardiovascular outcomes of patients with symptomatic ARVD/C and ER. Methods A total of 59 consecutive ARVD/C patients hospitalized for catheter ablation, presenting with and without J-point elevations of ≥ 0.1 mV in at least 2 inferior leads or lateral leads were enrolled. Clinical characteristics, electrophysiological study, substrate mapping, catheter ablation, and future clinical outcomes in a prospective patient registry were investigated. Results ER was observed in 38 patients (64.4%). Among these patients, ER was found in the inferior leads in 18 patients (47.4%), in the lateral leads in 2 patients (5.3%), and in both inferior and lateral leads in 18 patients (47.4%). Patients exhibiting ER were commonly men, had lower right ventricular ejection fraction, had higher incidence of clinical ventricular fibrillation or aborted sudden cardiac death, had more defibrillator implantations, had higher the need of epicardial ablation, and had more major criteria according to the task force criteria. Significant higher incidence of induced ventricular fibrillation and shorter tachycardia cycle length of induced ventricular tachycardia were found during procedure. The recurrence rate of ventricular arrhythmias did not differ between patients with and without ER after catheter ablation. Conclusions A high prevalence of electrocardiographic ER was found among symptomatic ARVD/C patients undergoing catheter ablation. ER in 12-lead ECG is associated with an increased risk of clinical fatal ventricular arrhythmias.

AB - Abstract Background The clinical characteristics and prognostic value of early repolarization (ER) in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) and symptomatic ventricular arrhythmias remain unclear. We investigated the prevalence, clinical features, and cardiovascular outcomes of patients with symptomatic ARVD/C and ER. Methods A total of 59 consecutive ARVD/C patients hospitalized for catheter ablation, presenting with and without J-point elevations of ≥ 0.1 mV in at least 2 inferior leads or lateral leads were enrolled. Clinical characteristics, electrophysiological study, substrate mapping, catheter ablation, and future clinical outcomes in a prospective patient registry were investigated. Results ER was observed in 38 patients (64.4%). Among these patients, ER was found in the inferior leads in 18 patients (47.4%), in the lateral leads in 2 patients (5.3%), and in both inferior and lateral leads in 18 patients (47.4%). Patients exhibiting ER were commonly men, had lower right ventricular ejection fraction, had higher incidence of clinical ventricular fibrillation or aborted sudden cardiac death, had more defibrillator implantations, had higher the need of epicardial ablation, and had more major criteria according to the task force criteria. Significant higher incidence of induced ventricular fibrillation and shorter tachycardia cycle length of induced ventricular tachycardia were found during procedure. The recurrence rate of ventricular arrhythmias did not differ between patients with and without ER after catheter ablation. Conclusions A high prevalence of electrocardiographic ER was found among symptomatic ARVD/C patients undergoing catheter ablation. ER in 12-lead ECG is associated with an increased risk of clinical fatal ventricular arrhythmias.

KW - Arrhythmogenic right ventriculardysplasia/cardiomyopathy

KW - Catheter ablation

KW - Early repolarization

KW - Ventricular arrhythmia

UR - http://www.scopus.com/inward/record.url?scp=84938540112&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84938540112&partnerID=8YFLogxK

U2 - 10.1016/j.ijcard.2015.06.007

DO - 10.1016/j.ijcard.2015.06.007

M3 - Article

C2 - 26148770

AN - SCOPUS:84938540112

VL - 197

SP - 300

EP - 305

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

M1 - 20663

ER -