Heterogeneous response of J-wave syndromes to beta-adrenergic stimulation.

Détails

Ressource 1Télécharger: BIB_998A2C9D73C8.P001.pdf (809.24 [Ko])
Etat: Public
Version: Final published version
ID Serval
serval:BIB_998A2C9D73C8
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Heterogeneous response of J-wave syndromes to beta-adrenergic stimulation.
Périodique
Heart Rhythm
Auteur⸱e⸱s
Roten L., Derval N., Sacher F., Pascale P., Scherr D., Komatsu Y., Ramoul K., Daly M., Denis A., Shah A.J., Hocini M., Jaïs P., Haïssaguerre M.
ISSN
1556-3871 (Electronic)
ISSN-L
1547-5271
Statut éditorial
Publié
Date de publication
2012
Volume
9
Numéro
12
Pages
1970-1976
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article Publication Status: ppublish
Résumé
BACKGROUND: Inferolateral early repolarization (ER) and Brugada syndrome manifest with J waves. Isoproterenol suppresses recurrent ventricular arrhythmias while reducing J waves in both disorders.
OBJECTIVE: To characterize the effect of isoproterenol on J waves.
METHODS: We analyzed the impact of isoproterenol on J waves in 20 patients with Brugada-type electrocardiogram (Br group) and 38 patients with ER (ER group).
RESULTS: In the ER group, J waves were present in inferior leads in 32 patients (84%) and in lateral leads in 23 patients (61%). Isoproterenol increased the heart rate by 75 beats/min in the ER group and by 71 beats/min in the Br group (P = .20). The incidences of persistent (≤ 0.05-mV decrease), decreased, and normalized J waves (residual J wave ≤ 0.05 mV) were 20%, 80%, and 0% for Br group patients and 29%, 8%, and 63% for ER group patients, respectively (P <.001). Within the ER group, inferior J waves persisted in 34% of the cases, decreased in 9%, and normalized in 56% whereas lateral J waves always normalized (P <.001). Baseline QRS width was broader in ER group patients with persistent J waves (90 ms vs 80 ms; P = .003) and was unchanged with isoproterenol (90 ms; P = .19), whereas it decreased in the remaining patients (75 ms; P <.001).
CONCLUSIONS: J-wave syndromes have distinct regional sensitivity to beta-adrenergic stimulation. J waves may persist in a subset of patients with right precordial and inferior J waves but never in lateral location. This heterogeneous response to isoproterenol may indicate distinctive mechanisms for Brugada and ER patterns, including depolarization abnormalities or ion channel sensitivity.
Mots-clé
Adrenergic beta-Agonists/administration & dosage, Adult, Brugada Syndrome/drug therapy, Brugada Syndrome/physiopathology, Electrocardiography/drug effects, Female, Follow-Up Studies, Heart Rate/drug effects, Humans, Isoproterenol/administration & dosage, Male, Treatment Outcome
Pubmed
Web of science
Création de la notice
21/07/2014 9:41
Dernière modification de la notice
20/08/2019 16:01
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