Sudden cardiac arrest associated with early repolarization
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Sudden cardiac arrest associated with early repolarization. / Haïssaguerre, Michel; Derval, Nicolas; Sacher, Frederic; Jesel, Laurence; Deisenhofer, Isabel; de Roy, Luc; Pasquié, Jean-Luc; Nogami, Akihiko; Babuty, Dominique; Yli-Mayry, Sinikka; De Chillou, Christian; Scanu, Patrice; Mabo, Philippe; Matsuo, Seiichiro; Probst, Vincent; Le Scouarnec, Solena; Defaye, Pascal; Schlaepfer, Juerg; Rostock, Thomas; Lacroix, Dominique; Lamaison, Dominique; Lavergne, Thomas; Aizawa, Yoshifusa; Englund, Anders; Anselme, Frederic; O'Neill, Mark; Hocini, Meleze; Lim, Kang Teng; Knecht, Sebastien; Veenhuyzen, George D; Bordachar, Pierre; Chauvin, Michel; Jais, Pierre; Coureau, Gaelle; Chene, Genevieve; Klein, George J; Clémenty, Jacques.
in: NEW ENGL J MED, Jahrgang 358, Nr. 19, 08.05.2008, S. 2016-2023.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Sudden cardiac arrest associated with early repolarization
AU - Haïssaguerre, Michel
AU - Derval, Nicolas
AU - Sacher, Frederic
AU - Jesel, Laurence
AU - Deisenhofer, Isabel
AU - de Roy, Luc
AU - Pasquié, Jean-Luc
AU - Nogami, Akihiko
AU - Babuty, Dominique
AU - Yli-Mayry, Sinikka
AU - De Chillou, Christian
AU - Scanu, Patrice
AU - Mabo, Philippe
AU - Matsuo, Seiichiro
AU - Probst, Vincent
AU - Le Scouarnec, Solena
AU - Defaye, Pascal
AU - Schlaepfer, Juerg
AU - Rostock, Thomas
AU - Lacroix, Dominique
AU - Lamaison, Dominique
AU - Lavergne, Thomas
AU - Aizawa, Yoshifusa
AU - Englund, Anders
AU - Anselme, Frederic
AU - O'Neill, Mark
AU - Hocini, Meleze
AU - Lim, Kang Teng
AU - Knecht, Sebastien
AU - Veenhuyzen, George D
AU - Bordachar, Pierre
AU - Chauvin, Michel
AU - Jais, Pierre
AU - Coureau, Gaelle
AU - Chene, Genevieve
AU - Klein, George J
AU - Clémenty, Jacques
N1 - Copyright 2008 Massachusetts Medical Society.
PY - 2008/5/8
Y1 - 2008/5/8
N2 - BACKGROUND: Early repolarization is a common electrocardiographic finding that is generally considered to be benign. Its potential to cause cardiac arrhythmias has been hypothesized from experimental studies, but it is not known whether there is a clinical association with sudden cardiac arrest.METHODS: We reviewed data from 206 case subjects at 22 centers who were resuscitated after cardiac arrest due to idiopathic ventricular fibrillation and assessed the prevalence of electrocardiographic early repolarization. The latter was defined as an elevation of the QRS-ST junction of at least 0.1 mV from baseline in the inferior or lateral lead, manifested as QRS slurring or notching. The control group comprised 412 subjects without heart disease who were matched for age, sex, race, and level of physical activity. Follow-up data that included the results of monitoring with an implantable defibrillator were obtained for all case subjects.RESULTS: Early repolarization was more frequent in case subjects with idiopathic ventricular fibrillation than in control subjects (31% vs. 5%, P<0.001). Among case subjects, those with early repolarization were more likely to be male and to have a history of syncope or sudden cardiac arrest during sleep than those without early repolarization. In eight subjects, the origin of ectopy that initiated ventricular arrhythmias was mapped to sites concordant with the localization of repolarization abnormalities. During a mean (+/-SD) follow-up of 61+/-50 months, defibrillator monitoring showed a higher incidence of recurrent ventricular fibrillation in case subjects with a repolarization abnormality than in those without such an abnormality (hazard ratio, 2.1; 95% confidence interval, 1.2 to 3.5; P=0.008).CONCLUSIONS: Among patients with a history of idiopathic ventricular fibrillation, there is an increased prevalence of early repolarization.
AB - BACKGROUND: Early repolarization is a common electrocardiographic finding that is generally considered to be benign. Its potential to cause cardiac arrhythmias has been hypothesized from experimental studies, but it is not known whether there is a clinical association with sudden cardiac arrest.METHODS: We reviewed data from 206 case subjects at 22 centers who were resuscitated after cardiac arrest due to idiopathic ventricular fibrillation and assessed the prevalence of electrocardiographic early repolarization. The latter was defined as an elevation of the QRS-ST junction of at least 0.1 mV from baseline in the inferior or lateral lead, manifested as QRS slurring or notching. The control group comprised 412 subjects without heart disease who were matched for age, sex, race, and level of physical activity. Follow-up data that included the results of monitoring with an implantable defibrillator were obtained for all case subjects.RESULTS: Early repolarization was more frequent in case subjects with idiopathic ventricular fibrillation than in control subjects (31% vs. 5%, P<0.001). Among case subjects, those with early repolarization were more likely to be male and to have a history of syncope or sudden cardiac arrest during sleep than those without early repolarization. In eight subjects, the origin of ectopy that initiated ventricular arrhythmias was mapped to sites concordant with the localization of repolarization abnormalities. During a mean (+/-SD) follow-up of 61+/-50 months, defibrillator monitoring showed a higher incidence of recurrent ventricular fibrillation in case subjects with a repolarization abnormality than in those without such an abnormality (hazard ratio, 2.1; 95% confidence interval, 1.2 to 3.5; P=0.008).CONCLUSIONS: Among patients with a history of idiopathic ventricular fibrillation, there is an increased prevalence of early repolarization.
KW - Actuarial Analysis
KW - Adult
KW - Anti-Arrhythmia Agents/therapeutic use
KW - Arrhythmias, Cardiac/epidemiology
KW - Cardiac Electrophysiology
KW - Case-Control Studies
KW - Catheter Ablation
KW - Death, Sudden, Cardiac/etiology
KW - Defibrillators, Implantable
KW - Electrocardiography
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Middle Aged
KW - Prevalence
KW - Recurrence
KW - Statistics, Nonparametric
KW - Ventricular Fibrillation/complications
U2 - 10.1056/NEJMoa071968
DO - 10.1056/NEJMoa071968
M3 - SCORING: Journal article
C2 - 18463377
VL - 358
SP - 2016
EP - 2023
JO - NEW ENGL J MED
JF - NEW ENGL J MED
SN - 0028-4793
IS - 19
ER -