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Mode and Characteristics of Arrhythmia Initiation in Idiopathic Ventricular Fibrillation: A THESIS Substudy
B. Belhassen, G. Conte, C. Steinberg, J. Whitaker, HR. Khan, M. Laredo, F. Doldi, R. Ho, R. Tadros, B. Dinov, E. Chorin, S. Hansom, X. Waintraub, L. Eckardt, L. Jankelson, P. Peichl, G. Mellor, RW. Sy, P. Rattanawong, S. Stojkovic, L. Garber, G....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, multicentrická studie
- MeSH
- dospělí MeSH
- elektrokardiografie MeSH
- fibrilace komor * epidemiologie MeSH
- katetrizační ablace MeSH
- komorová tachykardie patofyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
BACKGROUND: There is limited information on the mode of arrhythmia initiation in idiopathic ventricular fibrillation (IVF). A non-pause-dependent mechanism has been suggested to be the rule. OBJECTIVES: The aim of this study was to assess the mode and characteristics of initiation of polymorphic ventricular tachycardia (PVT) in patients with short or long-coupled PVT/IVF included in THESIS (THerapy Efficacy in Short or long-coupled idiopathic ventricular fibrillation: an International Survey), a multicenter study involving 287 IVF patients treated with drugs or radiofrequency ablation. METHODS: We reviewed the initiation of 410 episodes of ≥1 PVT triplet in 180 patients (58.3% females; age 39.6 ± 13.6 years) with IVF. The incidence of pause-dependency arrhythmia initiation (prolongation by >20 ms of the preceding cycle length) was assessed. RESULTS: Most arrhythmias (n = 295; 72%) occurred during baseline supraventricular rhythm without ambient premature ventricular complexes (PVCs), whereas 106 (25.9%) occurred during baseline rhythm including PVCs. Nine (2.2%) arrhythmias occurred during atrial/ventricular pacing and were excluded from further analysis. Mode of PVT initiation was pause-dependent in 45 (15.6%) and 64 (60.4%) of instances in the first and second settings, respectively, for a total of 109 of 401 (27.2%). More than one type of pause-dependent and/or non-pause-dependent initiation (mean: 2.6) occurred in 94.4% of patients with ≥4 events. Coupling intervals of initiating PVCs were <350 ms, 350-500 ms, and >500 ms in 76.6%, 20.72%, and 2.7% of arrhythmia initiations, respectively. CONCLUSIONS: Pause-dependent initiation occurred in more than a quarter of arrhythmic episodes in IVF patients. PVCs having long (between 350 and 500 ms) and very long (>500 ms) coupling intervals were observed at the initiation of nearly a quarter of PVT episodes.
Arrhythmia and Electrophysiology Department IRCCS Policlinico San Donato Milan Italy
Cardiac Electrophysiology St Bartholomew's Hospital London United Kingdom
Cardiology Department Hospital Universitario Virgen de las Nieves Granada Spain
Cardiology Division Department of Medicine Brigham and Women's Hospital Boston Massachusetts USA
Department of Cardiology 2 University Hospital Münster Münster Germany
Department of Cardiology CHRU Nancy Université de Lorraine Nancy France
Department of Cardiology Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
Department of Cardiology Electrophysiology Skaraborgs Sjukhus Skövde Sweden
Department of Cardiology IKEM Prague Czech Republic
Department of Cardiology Inselspital Bern University Hospital University of Bern Bern Switzerland
Department of Cardiology King's College Hospital London UK
Department of Cardiology Papworth Hospital NHS Foundation Trust Cambridge UK
Department of Cardiology Tel Aviv Sourasky Medical Center and Tel Aviv University Tel Aviv Israel
Department of Cardiology University Hospital Geneva Switzerland
Department of Cardiovascular Medicine Mayo Clinic Phoenix Arizona USA
Department of Electrophysiology Heart Center University Leipzig Leipzig Germany
Division of Cardiology Cardiocentro Ticino Institute Ente Ospedaliero Cantonale Lugano Switzerland
Division of Cardiology University of Washington Seattle Washington USA
Heart Institute Hadassah Medical Center Jerusalem and Tel Aviv University Tel Aviv Israel
Heart Institute Hadassah Medical Center Jerusalem Israel
Houston Methodist DeBakey Heart and Vascular Center and Research Institute Houston Texas USA
Institut de Cardiologie Groupe Hospitalier Pitié Salpêtrière and Sorbonne Université Paris France
Institut Universitaire de Cardiologie et Pneumologie de Québec Laval University Quebec Canada
Institute for Genetics of Heart Diseases University Hospital Münster Münster Germany
Jesselson Integrated Heart Center Shaare Zedek Medical Center Jerusalem Israel
Leeds Teaching Hospitals NHS Trust Leeds UK
Unidad de Arritmias Servicio de Cardiología Hospital Universitario de Burgos Burgos Spain
Citace poskytuje Crossref.org
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- $a Belhassen, Bernard $u Heart Institute, Hadassah Medical Center, Jerusalem, and Tel-Aviv University, Tel-Aviv, Israel. Electronic address: bblhass@gmail.com
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- $a Mode and Characteristics of Arrhythmia Initiation in Idiopathic Ventricular Fibrillation: A THESIS Substudy / $c B. Belhassen, G. Conte, C. Steinberg, J. Whitaker, HR. Khan, M. Laredo, F. Doldi, R. Ho, R. Tadros, B. Dinov, E. Chorin, S. Hansom, X. Waintraub, L. Eckardt, L. Jankelson, P. Peichl, G. Mellor, RW. Sy, P. Rattanawong, S. Stojkovic, L. Garber, G. Suna, J. Kautzner, KH. Chan, K. Srivathsan, U. Tedrow, S. Havranek, F. Murgatroyd, A. Shauer, BG. Winkel, SP. Page, A. Milman, A. Lador, R. Ayou, JM. Sellal, P. Chevalier, FJ. García-Fernández, T. Reichlin, D. Shah, B. Nazer, F. Bermudez-Jimenez, S. Nagase, H. Morita, GB. Nam, C. Pappone, PD. Lambiase, B. Strohmer, M. Stuehlinger, E. Gandjbakhch, E. Schulze-Bahr, AD. Krahn, O. Tovia-Brodie, THESIS Investigators
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- $a BACKGROUND: There is limited information on the mode of arrhythmia initiation in idiopathic ventricular fibrillation (IVF). A non-pause-dependent mechanism has been suggested to be the rule. OBJECTIVES: The aim of this study was to assess the mode and characteristics of initiation of polymorphic ventricular tachycardia (PVT) in patients with short or long-coupled PVT/IVF included in THESIS (THerapy Efficacy in Short or long-coupled idiopathic ventricular fibrillation: an International Survey), a multicenter study involving 287 IVF patients treated with drugs or radiofrequency ablation. METHODS: We reviewed the initiation of 410 episodes of ≥1 PVT triplet in 180 patients (58.3% females; age 39.6 ± 13.6 years) with IVF. The incidence of pause-dependency arrhythmia initiation (prolongation by >20 ms of the preceding cycle length) was assessed. RESULTS: Most arrhythmias (n = 295; 72%) occurred during baseline supraventricular rhythm without ambient premature ventricular complexes (PVCs), whereas 106 (25.9%) occurred during baseline rhythm including PVCs. Nine (2.2%) arrhythmias occurred during atrial/ventricular pacing and were excluded from further analysis. Mode of PVT initiation was pause-dependent in 45 (15.6%) and 64 (60.4%) of instances in the first and second settings, respectively, for a total of 109 of 401 (27.2%). More than one type of pause-dependent and/or non-pause-dependent initiation (mean: 2.6) occurred in 94.4% of patients with ≥4 events. Coupling intervals of initiating PVCs were <350 ms, 350-500 ms, and >500 ms in 76.6%, 20.72%, and 2.7% of arrhythmia initiations, respectively. CONCLUSIONS: Pause-dependent initiation occurred in more than a quarter of arrhythmic episodes in IVF patients. PVCs having long (between 350 and 500 ms) and very long (>500 ms) coupling intervals were observed at the initiation of nearly a quarter of PVT episodes.
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