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J Am Coll Cardiol. 2015 Jan 20;65(2):151-9. doi: 10.1016/j.jacc.2014.10.043.

Role of electrophysiological studies in predicting risk of ventricular arrhythmia in early repolarization syndrome.

Author information

1
Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France. Electronic address: saagar7m7@yahoo.co.uk.
2
Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France.
3
AP-HP, Hôpital Bichat, Service de Cardiologie et Centre de Référence des Maladies Cardiaques Héréditaires, INSERM, U698, Université Paris Diderot, Paris, France.
4
Deutsches Herzzentrum München, Munich, Germany.
5
Centre Hospitalier Universitaire de Tours, Tours, France.
6
Service de Cardiologie, CHUV, Lausanne, Switzerland.
7
Clinique Mont Godinne Leuven, Leuven, Belgium.
8
Groupe Hospitalier Pitié Salpêtrière, Paris, France.
9
Tampere University Hospital, Tampere, Finland.
10
Centre Hospitalier Universitaire de Rennes, Rennes, France.
11
Eppendorf Hospital, Hamburg, Germany.
12
University of Tsukuba, Tsukuba, Japan.
13
Centre Hospitalier Universitaire de Montpellier, Montpellier, France.
14
Centre Hospitalier Universitaire de Nancy, Nancy, France.
15
Institute for Clinical and Experimental Medicine, Department of Cardiology, Prague, Czech Republic.
16
Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France.
17
Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
18
Centre Hospitalier Universitaire de Nantes, Nantes, France.

Erratum in

  • J Am Coll Cardiol. 2015 Mar 24;65(11):1158.

Abstract

BACKGROUND:

The early repolarization (ER) pattern is associated with an increased risk of arrhythmogenic sudden death. However, strategies for risk stratification of patients with the ER pattern are not fully defined.

OBJECTIVES:

This study sought to determine the role of electrophysiology studies (EPS) in risk stratification of patients with ER syndrome.

METHODS:

In a multicenter study, 81 patients with ER syndrome (age 36 ± 13 years, 60 males) and aborted sudden death due to ventricular fibrillation (VF) were included. EPS were performed following the index VF episode using a standard protocol. Inducibility was defined by the provocation of sustained VF. Patients were followed up by serial implantable cardioverter-defibrillator interrogations.

RESULTS:

Despite a recent history of aborted sudden death, VF was inducible in only 18 of 81 (22%) patients. During follow-up of 7.0 ± 4.9 years, 6 of 18 (33%) patients with inducible VF during EPS experienced VF recurrences, whereas 21 of 63 (33%) patients who were noninducible experienced recurrent VF (p = 0.93). VF storm occurred in 3 patients from the inducible VF group and in 4 patients in the noninducible group. VF inducibility was not associated with maximum J-wave amplitude (VF inducible vs. VF noninducible; 0.23 ± 0.11 mV vs. 0.21 ± 0.11 mV; p = 0.42) or J-wave distribution (inferior, odds ratio [OR]: 0.96 [95% confidence interval (CI): 0.33 to 2.81]; p = 0.95; lateral, OR: 1.57 [95% CI: 0.35 to 7.04]; p = 0.56; inferior and lateral, OR: 0.83 [95% CI: 0.27 to 2.55]; p = 0.74), which have previously been demonstrated to predict outcome in patients with an ER pattern.

CONCLUSIONS:

Our findings indicate that current programmed stimulation protocols do not enhance risk stratification in ER syndrome.

KEYWORDS:

early repolarization; sudden cardiac death; ventricular fibrillation

PMID:
25593056
DOI:
10.1016/j.jacc.2014.10.043
[Indexed for MEDLINE]
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