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Belhassen, B; Conte, G; Steinberg, C; Whitaker, J; Khan, HR; Laredo, M; Doldi, F; Ho, R; Tadros, R; Dinov, B; Chorin, E; Hansom, S; Waintraub, X; Eckardt, L; Jankelson, L; Peichl, P; Mellor, G; Sy, RW; Rattanawong, P; Stojkovic, S; Garber, L; Suna, G; Kautzner, J; Chan, KH; Srivathsan, K; Tedrow, U; Havranek, S; Murgatroyd, F; Shauer, A; Winkel, BG; Page, SP; Milman, A; Lador, A; Ayou, R; Sellal, JM; Chevalier, P; García-Fernández, FJ; Reichlin, T; Shah, D; Nazer, B; Bermudez-Jimenez, F; Nagase, S; Morita, H; Nam, GB; Pappone, C; Lambiase, PD; Strohmer, B; Stuehlinger, M; Gandjbakhch, E; Schulze-Bahr, E; Krahn, AD; Tovia-Brodie, O, , THESIS, Investigators.
Mode and Characteristics of Arrhythmia Initiation in Idiopathic Ventricular Fibrillation: A THESIS Substudy.
JACC Clin Electrophysiol. 2024; 10(8):1794-1809 Doi: 10.1016/j.jacep.2024.03.036
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Scherr Daniel
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Abstract:
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.
Find related publications in this database (using NLM MeSH Indexing)
Humans - administration & dosage
Female - administration & dosage
Ventricular Fibrillation - epidemiology
Male - administration & dosage
Middle Aged - administration & dosage
Adult - administration & dosage
Tachycardia, Ventricular - physiopathology
Catheter Ablation - administration & dosage
Young Adult - administration & dosage
Electrocardiography - administration & dosage

Find related publications in this database (Keywords)
idiopathic ventricular fibrillation
long-coupled ventricular arrhythmias
pause-dependency
polymorphic ventricular tachycardia
short-coupled ventricular arrhythmias
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