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Nakayama M, Matsuo H, Sato T, Okabe M, Aizawa Y. Is ischemic stimulus involved for J wave augmentation during coronary angiography and intracoronary administration of normal saline? Pacing Clin Electrophysiol 2024; 47:1065-1072. [PMID: 38852066 DOI: 10.1111/pace.15005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/02/2024] [Accepted: 05/10/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND J waves may be augmented by coronary angiography (CAG) or intracoronary drug administration but the underlying mechanism is unknown. PURPOSE The effect of intracoronary normal saline (NS) on J waves were investigated. PATIENTS AND METHODS After the standard CAG using iopamidol (IopamiroR Inj), NS was injected into the right coronary artery in 10 patients with and eight patients without J waves at the baseline. The 12-lead ECG was monitored, stored on a computer and retrieved later for measurement of the J wave amplitude before or during the coronary interventions. RESULTS J waves in leads II, III and aVF at baseline increased significantly in each lead during the right CAG and NS injection into the right coronary artery. The J wave changes were similar between the two interventions and distinct similar alterations were observed in the QRS complex. We postulated that the ischemic myocardium that was induced during CAG or intracoronary NS administration slowed the conduction velocity of depolarization in the perfusion territory and delayed the timing of J waves to appear. Then, the delayed appearance of J waves would be less opposed by electromotive force from other areas resulting in augmentation. CONCLUSION J wave augmentation was observed during CAG and intracoronary NS administration. As a mechanism of augmentation, we postulated that contrast media and NS induce myocardial ischemia and delay the timing of J waves to a point of less opposition by electromotive force from other areas. HIGHLIGHTS J wave augmentation has been reported during intracoronary injection of contrast media or drugs. The present study confirmed that normal saline alone was able to augment J waves. Mechanistically, coronary interventions using anoxic solutions can cause regional myocardial ischemia and reduce the conduction velocity of depolarization. Then, delayed J waves are less opposed by the electromotive force from remote areas which leads to augmentation. When a drug is diluted in normal saline and given intracoronarily, changes in J waves can be due to normal saline. The pathophysiological and clinical significance of J waves augmented during coronary interventions need to be established.
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Affiliation(s)
- Masafumi Nakayama
- Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan
- Department of Cardiology, Tokyo D Tower Hospital, Tokyo, Japan
| | - Hitoshi Matsuo
- Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan
| | - Takao Sato
- Department of Cardiology, Tachikawa General Hospital, Nagaoka, Japan
| | - Masaaki Okabe
- Department of Cardiology, Tachikawa General Hospital, Nagaoka, Japan
| | - Yoshifusa Aizawa
- Research and Development Division, Tachikawa Medical Center, Nagaoka, Japan
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Hagiwara A, Sato A, Kitazawa H, Aizawa Y. J Waves Augmented by Isoproterenol and Pacing. Intern Med 2023; 62:2753-2754. [PMID: 36642521 PMCID: PMC10569922 DOI: 10.2169/internalmedicine.1081-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/01/2022] [Indexed: 01/15/2023] Open
Affiliation(s)
- Akari Hagiwara
- Department of Cardiology, Tachikawa General Hospital, Japan
| | - Akinori Sato
- Department of Cardiology, Tachikawa General Hospital, Japan
| | | | - Yoshifusa Aizawa
- Devision of Research and Development, Tachikawa Medical Center, Japan
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Aizawa Y, Ohashi N, Kawamura A, Ogawa S, Aizawa Y. J wave dynamicity during coronary angiography and intracoronary acetylcholine administration. Pacing Clin Electrophysiol 2023; 46:868-874. [PMID: 37461879 DOI: 10.1111/pace.14787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/27/2023] [Accepted: 07/01/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND J-waves may be observed during coronary angiography (CAG) or intracoronary acetylcholine (ACh) administration, but their significance is unknown. METHODS Forty-nine patients, 59.1 ± 11.5 years old and 59% male, were studied on suspicion of vasospastic angina, and J wave dynamicity was compared between CAG and Ach administration. RESULTS Diagnostic (≥0.1 mV) or nondiagnostic (<0.1 mV) J waves in 9 and 3 patients, respectively, were augmented, and J waves were newly observed in 2 patients during CAG and Ach administration. Similar changes in the J-wave amplitude were observed: from 0.10 ± 0.09 mV to 0.20 ± 0.15 mV (p < .002) and from 0.10 ± 0.10 mV to 0.20 ± 0.16 mV (p < .001) during CAG and Ach administration, respectively. J waves were located in the inferior leads and changed only during the right coronary interventions. In the remaining 35 patients, J waves were absent before and during the coronary interventions. Augmentation of J waves was found when the RR interval was shortened in some patients. Injection of anoxic media into the coronary artery might induce a conduction delay from myocardial ischemia that manifests as augmentation or new occurrence of J waves. CONCLUSIONS Both CAG and intracoronary Ach administration affected J waves similarly in the same individuals. A myocardial ischemia-induced conduction delay may be responsible for the changes in J waves, but further studies are needed.
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Affiliation(s)
- Yoshiyasu Aizawa
- Department of Cardiology, International University of Health and Welfare Narita Hospital, Narita, Chiba, Japan
| | - Narutaka Ohashi
- Department of Cardiology, International University of Health and Welfare Narita Hospital, Narita, Chiba, Japan
| | - Akio Kawamura
- Department of Cardiology, International University of Health and Welfare Narita Hospital, Narita, Chiba, Japan
| | - Satoshi Ogawa
- Department of Cardiology, International University of Health and Welfare Mita Hospital, Minato-ku, Tokyo, Japan
| | - Yoshifusa Aizawa
- Department of Research and Development, Tachikawa Medical Center, Nagaoka, Japan
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Zhou X, Ren L, Huang J, Zhang Y, Cai Y, Pu J. Novel SCN5A frame‑shift mutation underlying in patient with idiopathic ventricular fibrillation manifested with J wave in inferior lead and prolonged S‑wave in precordial lead. Exp Ther Med 2023; 25:287. [PMID: 37206574 PMCID: PMC10189605 DOI: 10.3892/etm.2023.11986] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 02/01/2023] [Indexed: 05/21/2023] Open
Abstract
Mutations in the SCN5A gene has been recognized as resulting in a series of life-threatening arrhythmias. However, it also causes idiopathic ventricular fibrillation (IVF) with J wave in inferior leads and prolonged S-wave upstroke in precordial leads, which has not been previously reported. The present study aimed to study the mechanisms of a patient with IVF manifested with J wave in inferior leads and prolonged S-wave upstroke in precordial leads. The electrocardiograms (ECG) of the proband were recorded and genetic testing was conducted. Patch-clamp and immunocytochemical studies were performed in heterologously transfected 293 cells. The VF attacks was documented in a 55-year-old male proband with syncope episodes. 12-lead ECG shown the transient J wave in the inferior leads and prolonged S-wave upstroke in precordial V1-V3 leads in the same timeframe. Genetic analysis revealed a novel 1 base deletion (G) at position 839 in exon 2 in SCN5A gene (C280S*fs61), which causes a severe truncation of the sodium channel. The functional study revealed that in 293 cells transfected with mutant channel, no sodium current could be recorded even though the immunocytochemical experiment confirmed the truncated sodium channel existed in cytosol. The kinetics of the wild-type (WT) channel were not altered when co-transfected with C280S*fs61 mutant which suggested a haploinsufficiency effect of sodium channel in the cells. The present study identified a novel C280Sfs*61 mutation that caused the 'loss of function' of the sodium channel by haploinsufficiency mechanism. The reduced sodium channel function in the heart may cause conduction delay that may underlie the manifestation of J wave and prolonged S-wave upstroke associated with IVF.
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Affiliation(s)
- Xiaoqian Zhou
- Department of Cardiology, Shanghai East Hospital, Tongji University, Shanghai 100123, P.R. China
| | - Lan Ren
- Department of Cardiology, Beijing Jishuitan Hospital, Beijing 100035, P.R. China
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100037, P.R. China
| | - Jian Huang
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100037, P.R. China
| | - Yinhui Zhang
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100037, P.R. China
| | - Ying Cai
- Department of Cardiology, Shanghai East Hospital, Tongji University, Shanghai 100123, P.R. China
- Correspondence to: Professor Jielin Pu and Professor Ying Cai, Department of Cardiology, Shanghai East Hospital, Tongji University, 1800 Yuntai Road, Pudong, Shanghai 100123, P.R. China
| | - Jielin Pu
- Department of Cardiology, Shanghai East Hospital, Tongji University, Shanghai 100123, P.R. China
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100037, P.R. China
- Correspondence to: Professor Jielin Pu and Professor Ying Cai, Department of Cardiology, Shanghai East Hospital, Tongji University, 1800 Yuntai Road, Pudong, Shanghai 100123, P.R. China
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Takahashi M, Kondo H, Yonezu K, Shinohara T, Nakagawa M, Takahashi N. Atrial Fibrillation-triggered Ventricular Fibrillation in a Patient with Early Repolarization Syndrome. Intern Med 2022; 61:1973-1976. [PMID: 34776496 PMCID: PMC9334228 DOI: 10.2169/internalmedicine.8716-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 54-year-old man with early repolarization syndrome (ERS) implanted with an implantable cardioverter-defibrillator (ICD) developed persistent atrial fibrillation (AF) three years after the implantation. Similarly, the remote monitoring system begun frequently detecting ventricular fibrillation (VF) and polymorphic ventricular tachycardia (PVT). Longer RR intervals were repeatedly observed just before the initiation of PVT/VF. Catheter ablation for AF successfully diminished both the PVT and VF events.
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Affiliation(s)
- Masaki Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Japan
| | - Hidekazu Kondo
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Japan
| | - Keisuke Yonezu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Japan
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Japan
| | - Mikiko Nakagawa
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Japan
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Japan
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Sakaguchi Y, Sato T, Sato A, Fuse K, Aizawa Y, Okabe M, Aizawa Y. Incidence and Implications of J waves Observed During Coronary Angiography. Am J Cardiol 2022; 163:32-37. [PMID: 34774283 DOI: 10.1016/j.amjcard.2021.09.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/18/2021] [Accepted: 09/21/2021] [Indexed: 11/01/2022]
Abstract
J waves may be observed during coronary angiography (CAG), but they have not been fully studied. We investigated the characteristics of J waves in 100 consecutive patients during CAG. The patients and their family members had no history of cardiac arrest. Approximately 60% of patients had ischemic heart disease, previous myocardial infarction, or angina pectoris, but at the time of this study, the right coronary artery was shown to be normal or patent after stenting. Electrocardiogram was serially recorded to monitor J waves and alteration of the QRS complex during CAG. In 12 patients (12%), J waves (0.249 ± 0.074 mV) newly appeared during right CAG, and in another 13 patients (13%), preexisting J waves increased from 0.155 ± 0.060 mV to 0.233 ± 0.133 mV during CAG. Left CAG induced no J waves or augmentation of J waves. Distinct alterations were observed in the QRS complex during CAG of both coronary arteries. Mechanistically, myocardial ischemia induced by contrast medium was considered to result in a local conduction delay, and when it occurred in the inferior wall, the site of the late activation of the ventricle, the conduction delay was manifested as J waves. In conclusion, J waves were confirmed to emerge or increase during angiography of the right but not the left coronary artery. Myocardial ischemia induced by contrast medium caused a local conduction delay that was manifested as J waves in the inferior wall, the site of the late activation of the ventricle.
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Im SI, Gwag HB, Park Y, Park SJ, Kim JS, On YK, Park KM. Electrocardiographic features of the presence of occult myocardial disease in patients with VPD-induced cardiomyopathy. J Arrhythm 2020; 36:485-492. [PMID: 32528576 PMCID: PMC7279975 DOI: 10.1002/joa3.12324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 02/03/2020] [Accepted: 02/17/2020] [Indexed: 11/16/2022] Open
Abstract
Background Frequent ventricular premature depolarizations (VPDs) can cause reversible cardiomyopathy (CMP). However, many patients maintain a normal left ventricular (LV) function with a high VPD burden. The electrocardiographic characteristics of VPD‐induced CMP have not been elucidated. Methods One hundred and eighty (91 men, age; 51 ± 15 years) patients with frequent idiopathic VPDs (>10% VPDs/day or >10 000 VPDs/day) were studied. All patients underwent successful ablation and were then divided into two groups according to the echocardiographic findings before and after the ablation procedure. Results Group A (n = 139) had a normal LV function with VPD frequencies, and Group B (n = 41) had reversible LV dysfunction after ablation. The VPD QRS duration (QRSd) was wider in patients with CMP (Group A vs Group B; 137.2 ± 12.0 milliseconds vs 159.7 ± 5.3 milliseconds, P < .001). VPDs with a terminal QRS delay marked by a notch followed by a discrete lower amplitude signal after the peak R wave in any precordial lead were identified. The incidence of terminal signals was higher in the CMP group (Group A vs Group B; 2.1% vs 53.6%, P < .001). Conclusions The wider VPD QRSd and terminal QRS delay in patients with VPD‐induced CMP suggest subclinical cell‐to‐cell conduction abnormalities as a potential factor predisposing VPD‐induced CMP.
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Affiliation(s)
- Sung Il Im
- Division of Cardiology Department of Internal Medicine Kosin University Gospel Hospital Kosin University College of Medicine Busan Republic of Korea
| | - Hye Bin Gwag
- Division of Cardiology Department of Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea
| | - Youngjun Park
- Division of Cardiology Department of Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea
| | - Seung-Jung Park
- Division of Cardiology Department of Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea
| | - June Soo Kim
- Division of Cardiology Department of Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea
| | - Young Keun On
- Division of Cardiology Department of Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea
| | - Kyoung-Min Park
- Division of Cardiology Department of Medicine Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Republic of Korea
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Nakayama M, Satomi K, Yuhara M, Uchiyama T, Aizawa Y, Aizawa Y. Conduction Delay-Induced J-Wave Augmentation in Patients With Coronary Heart Disease. Am J Cardiol 2019; 123:1262-1266. [PMID: 30711246 DOI: 10.1016/j.amjcard.2019.01.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/13/2019] [Accepted: 01/15/2019] [Indexed: 11/29/2022]
Abstract
Electrocardiogram records were surveyed for the presence of an atrial premature beat (APB) and J waves in patients with coronary heart disease and patients with noncardiac diseases. The prevalence and response of J waves to sudden shortening of the RR interval on the conducted APB were determined and compared between the 2 patients groups. The change in the QRS complexes on the APB was also determined. Among 17,013 patients, 243 patients who underwent percutaneous coronary intervention for acute myocardial infarction or angina pectoris had an APB, and J waves were observed in 16 patients (6.6%). In an additional 729 patients with noncardiac diseases and APB, 19 patients showed J waves (2.6%; p = 0.010). The clinical features were almost similar between the ischemic and nonischemic groups. J waves were located more often in inferior and high lateral leads in the ischemic group. When the RR interval shortened from 942 ± 228 to 621 ± 175 ms and 869 ± 158 to 570 ± 118 ms at baseline and in the conducted APB (p<0.001 for both), the J-wave amplitude increased from 0.16 ± 0.04 to 0.19 ± 0.06 mV (p<0.001) and 0.21 ± 0.07 to 0.24 ± 0.08 mV (p = 0.010) in the ischemic and nonischemic groups, respectively. J waves in patients with chronic coronary heart disease and in patients with noncardiac diseases were augmented at short RR intervals together with distinct changes in the QRS complexes, and an augmentation of J waves at short RR interval may represent a conduction delay.
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Affiliation(s)
- Masafumi Nakayama
- Cardiovascular Center, Toda Central General Hospital, Toda, Japan; Cooperative Major inAdvance Biomedical Science, Joint Graduate School of Tokyo, Women's Medical University, Waseda University and Tokyo Medical University, Tokyo, Japan
| | - Kazuhiro Satomi
- Cardiovascular Center, Toda Central General Hospital, Toda, Japan; Department of Cardiology, Tokyo Medical University, Tokyo, Japan
| | - Mikio Yuhara
- Cardiovascular Center, Toda Central General Hospital, Toda, Japan
| | - Takashi Uchiyama
- Cardiovascular Center, Toda Central General Hospital, Toda, Japan
| | - Yoshiyasu Aizawa
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Yoshifusa Aizawa
- Department of Research and Development, Tachikawa Medical Center, Nagaoka, Japan.
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Aizawa Y, Nakayama M, Sato M, Okabe M, Aizawa Y, Takatsuki S, Fukuda K. "J waves" induced after short coupling intervals: a manifestations of latent depolarization abnormality? Europace 2019; 20:f86-f92. [PMID: 28444176 DOI: 10.1093/europace/eux062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 02/15/2017] [Indexed: 11/12/2022] Open
Abstract
Aims To confirm the presence of tachycardia-induced slur or notch in the terminal portion of the QRS complexes in a general patient population. Methods and results A tachycardia-induced J wave was defined as a slur or notch in the terminal portion of the QRS complexes newly induced at short RR intervals during atrial premature contractions (APCs) or atrial electrical stimulation in the electrophysiological study (EPS). Twenty-three out of 2000 patients with general diseases were involved. All patients with aborted sudden cardiac death, ventricular fibrillation or a family history of sudden cardiac death were excluded. The mean age was 72 ± 9 years, and 11 patients were male (47.8%). When the RR interval was shortened from 821 ± 142 ms to 464 ± 52 ms in the conducted APCs (P < 0.0001), J waves became diagnostic (0.02 ± 0.03 mV to 0.20 ± 0.07 mV, P < 0.0001). J waves were confined to the inferior leads in 22 (95.7%) patients and were notched in 11 (47.8%) and slurred in 12 (52.2%) patients. The induction of J waves was accompanied by visible changes of the QRS morphology. When the post-APC RR interval was prolonged to 992 ± 305 ms (P = 0.0154 vs. baseline), the J waves were similar to baseline levels. During the EPS, J wave induction was confirmed during atrial stimulation. There were no characteristic clinical or ECG features in the patients with tachycardia-induced J waves. Conclusions J waves can be newly induced by short RR intervals in a general patient population, and a conduction delay is the likely mechanism causing such J waves.
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Affiliation(s)
- Yoshifusa Aizawa
- Tachikawa Medical Center, Niigata University, Kandacho, 3-2-1, Nagaoka, Niigata, Japan
| | - Masafumi Nakayama
- Cardiology, Tachikawa General Hospital, 3-2-11 Kandacho, Nagaoka, Japan
| | - Masahito Sato
- Cardiology, Tachikawa General Hospital, 3-2-11 Kandacho, Nagaoka, Japan
| | - Masaaki Okabe
- Cardiology, Tachikawa General Hospital, 3-2-11 Kandacho, Nagaoka, Japan
| | - Yoshiyasu Aizawa
- Internal Medicine, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku-kum, Tokyo, Japan
| | - Seiji Takatsuki
- Internal Medicine, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku-kum, Tokyo, Japan
| | - Keiichi Fukuda
- Internal Medicine, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku-kum, Tokyo, Japan
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Aizawa Y, Hosaka Y, Oda H, Fuse K, Okabe M, Kaneko Y, Takahashi N, Zaizen H, Aizawa Y, Fukuda K. Dynamicity of hypothermia-induced J waves and the mechanism involved. Heart Rhythm 2018; 16:74-80. [PMID: 30048693 DOI: 10.1016/j.hrthm.2018.07.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND J waves develop during hypothermia, but the dynamicity of hypothermia-induced J waves is poorly understood. OBJECTIVE The purpose of this study was to investigate the mechanism of the rate-dependent change in the amplitude of hypothermia-induced J waves. METHODS Nineteen patients with severe hypothermia were included (mean age 70 ± 12 years; 16 men [84.2%]). The rectal temperature at the time of admission was 27.8° ± 2.5°C. In addition to prolonged PR, QRS complex, and corrected QT intervals, the distribution of prominent J waves was widespread in all 19 patients. RESULTS Nine patients showed changes in RR intervals. When the RR interval shortened from 1353 ± 472 to 740 ± 391 ms (P = .0002), the J-wave amplitude increased from 0.50 ± 0.29 to 0.61 ±0.27 mV (P = .0075). The J-wave amplitude increased in 7 patients (77.8%) and decreased in 2 patients (22.2%) after short RR intervals. The augmentation of J waves at short RR intervals was associated with a significant prolongation of ventricular activation time (35 ± 5 ms vs 46 ± 5 ms; P = .0020), suggesting accentuated conduction delay. Increased conduction delay at short RR intervals was suggested to accentuate the phase 1 notch of the action potential and J waves in hypothermia. None developed ventricular fibrillation, and in 2 of 9 patients with atrial fibrillation, atrial fibrillation persisted after rewarming to normothermia. CONCLUSION J waves in severe hypothermia were augmented after short RR intervals in 7 patients as expected for depolarization abnormality, whereas 2 patients showed a bradycardia-dependent augmentation as expected for transient outward current-mediated J waves. Increased conduction delay at short RR intervals can be responsible for the accentuation of the transient outward current and J waves during severe hypothermia.
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Affiliation(s)
- Yoshifusa Aizawa
- Research and Development, Tachikawa Medical Center/Niigata University, Nagaoka/Niigata, Japan.
| | - Yukio Hosaka
- Department of Cardiology, Niigata City Hospital, Niigata, Japan
| | - Hirotaka Oda
- Department of Cardiology, Niigata City Hospital, Niigata, Japan
| | - Koichi Fuse
- Department of Cardiology, Tachikawa General Hospital, Nagaoka, Japan
| | - Masaaki Okabe
- Department of Cardiology, Tachikawa General Hospital, Nagaoka, Japan
| | - Yoshiaki Kaneko
- Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | | | - Hirofumi Zaizen
- Department of Internal Medicine, Koseiren Ttsurumi Hospital, Oita, Japan
| | - Yoshiyasu Aizawa
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
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Intracoronary acetylcholine-induced augmentation of J waves: A case of idiopathic ventricular fibrillation. HeartRhythm Case Rep 2018; 4:247-250. [PMID: 29928588 PMCID: PMC6007145 DOI: 10.1016/j.hrcr.2018.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Kamikubo Y, Inden Y, Nagao T, Aizawa Y, Murohara T. Different rate-dependent responses between J waves and the notches on an epicardial local electrogram in a patient with idiopathic ventricular fibrillation. HeartRhythm Case Rep 2017; 3:427-430. [PMID: 28948148 PMCID: PMC5601328 DOI: 10.1016/j.hrcr.2017.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Yosuke Kamikubo
- Department of Cardiology, Nagoya University School of Medicine, Nagoya, Japan
| | - Yasuya Inden
- Department of Cardiology, Nagoya University School of Medicine, Nagoya, Japan
| | - Tomoyuki Nagao
- Department of Cardiology, Nagoya University School of Medicine, Nagoya, Japan
| | - Yoshifusa Aizawa
- Division of Research and Development, Tachikawa Medical Center, Nagaoka, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University School of Medicine, Nagoya, Japan
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Fumimoto T, Ueyama T, Shimizu A, Yoshiga Y, Ono M, Kato T, Ishiguchi H, Okamura T, Yamada J, Yano M. Inferior J waves in patients with vasospastic angina might be a risk factor for ventricular fibrillation. J Cardiol 2017; 70:271-277. [DOI: 10.1016/j.jjcc.2016.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 12/08/2016] [Accepted: 12/12/2016] [Indexed: 10/20/2022]
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14
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Aizawa Y, Takatsuki S, Nishiyama T, Kimura T, Kohsaka S, Kaneko Y, Inden Y, Takahashi N, Nagase S, Aizawa Y, Fukuda K. Tachycardia-Induced J-Wave Changes in Patients With and Without Idiopathic Ventricular Fibrillation. Circ Arrhythm Electrophysiol 2017; 10:CIRCEP.117.005214. [DOI: 10.1161/circep.117.005214] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 06/12/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Yoshiyasu Aizawa
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Y.A., S.T., T.N., T.K., S.K., K.F.); Department of Cardiovascular Medicine Gunma University Graduate School of Medicine, Japan (Y.K.); Department of Cardiology, Nagoya University Graduate School of Medicine, Japan (Y.I.); Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Japan (N.T.); Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National
| | - Seiji Takatsuki
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Y.A., S.T., T.N., T.K., S.K., K.F.); Department of Cardiovascular Medicine Gunma University Graduate School of Medicine, Japan (Y.K.); Department of Cardiology, Nagoya University Graduate School of Medicine, Japan (Y.I.); Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Japan (N.T.); Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National
| | - Takahiko Nishiyama
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Y.A., S.T., T.N., T.K., S.K., K.F.); Department of Cardiovascular Medicine Gunma University Graduate School of Medicine, Japan (Y.K.); Department of Cardiology, Nagoya University Graduate School of Medicine, Japan (Y.I.); Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Japan (N.T.); Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National
| | - Takehiro Kimura
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Y.A., S.T., T.N., T.K., S.K., K.F.); Department of Cardiovascular Medicine Gunma University Graduate School of Medicine, Japan (Y.K.); Department of Cardiology, Nagoya University Graduate School of Medicine, Japan (Y.I.); Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Japan (N.T.); Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National
| | - Shun Kohsaka
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Y.A., S.T., T.N., T.K., S.K., K.F.); Department of Cardiovascular Medicine Gunma University Graduate School of Medicine, Japan (Y.K.); Department of Cardiology, Nagoya University Graduate School of Medicine, Japan (Y.I.); Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Japan (N.T.); Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National
| | - Yoshiaki Kaneko
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Y.A., S.T., T.N., T.K., S.K., K.F.); Department of Cardiovascular Medicine Gunma University Graduate School of Medicine, Japan (Y.K.); Department of Cardiology, Nagoya University Graduate School of Medicine, Japan (Y.I.); Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Japan (N.T.); Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National
| | - Yasuya Inden
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Y.A., S.T., T.N., T.K., S.K., K.F.); Department of Cardiovascular Medicine Gunma University Graduate School of Medicine, Japan (Y.K.); Department of Cardiology, Nagoya University Graduate School of Medicine, Japan (Y.I.); Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Japan (N.T.); Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National
| | - Naohiko Takahashi
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Y.A., S.T., T.N., T.K., S.K., K.F.); Department of Cardiovascular Medicine Gunma University Graduate School of Medicine, Japan (Y.K.); Department of Cardiology, Nagoya University Graduate School of Medicine, Japan (Y.I.); Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Japan (N.T.); Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National
| | - Satoshi Nagase
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Y.A., S.T., T.N., T.K., S.K., K.F.); Department of Cardiovascular Medicine Gunma University Graduate School of Medicine, Japan (Y.K.); Department of Cardiology, Nagoya University Graduate School of Medicine, Japan (Y.I.); Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Japan (N.T.); Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National
| | - Yoshifusa Aizawa
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Y.A., S.T., T.N., T.K., S.K., K.F.); Department of Cardiovascular Medicine Gunma University Graduate School of Medicine, Japan (Y.K.); Department of Cardiology, Nagoya University Graduate School of Medicine, Japan (Y.I.); Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Japan (N.T.); Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National
| | - Keichi Fukuda
- From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Y.A., S.T., T.N., T.K., S.K., K.F.); Department of Cardiovascular Medicine Gunma University Graduate School of Medicine, Japan (Y.K.); Department of Cardiology, Nagoya University Graduate School of Medicine, Japan (Y.I.); Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Japan (N.T.); Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National
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15
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Antzelevitch C, Yan GX, Ackerman MJ, Borggrefe M, Corrado D, Guo J, Gussak I, Hasdemir C, Horie M, Huikuri H, Ma C, Morita H, Nam GB, Sacher F, Shimizu W, Viskin S, Wilde AA. J-Wave syndromes expert consensus conference report: Emerging concepts and gaps in knowledge. Europace 2017; 19:665-694. [PMID: 28431071 PMCID: PMC5834028 DOI: 10.1093/europace/euw235] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
| | - Gan-Xin Yan
- Lankenau Medical Center, Wynnewood, Pennsylvania
| | - Michael J. Ackerman
- Departments of Cardiovascular Diseases, Pediatrics, and Molecular Pharmacology & Experimental Therapeutics, Divisions of Heart Rhythm Services and Pediatric Cardiology, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester,Minnesota
| | - Martin Borggrefe
- 1st Department of Medicine–Cardiology, University Medical Centre Mannheim, and DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Domenico Corrado
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy
| | - Jihong Guo
- Division of Cardiology, Peking University of People's Hospital, Beijing, China
| | - Ihor Gussak
- Rutgers University, New Brunswick, New Jersey
| | - Can Hasdemir
- Department of Cardiology, Ege University School of Medicine, Izmir, Turkey
| | - Minoru Horie
- Shiga University of Medical Sciences, Ohtsu, Shiga, Japan
| | - Heikki Huikuri
- Research Unit of Internal Medicine, Medical Research Center, Oulu University Hospital, and University of Oulu, Oulu, Finland
| | - Changsheng Ma
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, China
| | - Hiroshi Morita
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Gi-Byoung Nam
- Heart Institute, Asan Medical Center, and Department of Internal Medicine, University of Ulsan College of Medicine Seoul, Seoul, Korea
| | - Frederic Sacher
- Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Sami Viskin
- Tel-Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Arthur A.M. Wilde
- Heart Center, Department of Clinical and Experimental Cardiology, Academic Medical Center, University of Amsterdam, the Netherlands and Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders, Jeddah, Kingdom of Saudi Arabia
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16
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Intracoronary acetylcholine application as a possible probe inducing J waves in patients with early repolarization syndrome. J Arrhythm 2017; 33:424-429. [PMID: 29021844 PMCID: PMC5634679 DOI: 10.1016/j.joa.2016.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 12/18/2016] [Accepted: 12/27/2016] [Indexed: 12/11/2022] Open
Abstract
Acetylcholine is widely used for a diagnostic provocation test of coronary spasm in patients with vasospastic angina. Acetylcholine usually induces coronary vasodilatation mediated by muscarinic receptor activation, but sometimes it evokes vasoconstriction of coronary arteries where the endothelium is damaged. Early repolarization syndrome is characterized by a J wave observed at the end of the QRS complex in a surface electrocardiogram. The J wave is attributed to the transmural voltage gradient at the early repolarization phase across the ventricular wall, which stems mainly from prominent transient outward current in the epicardium, but not in the endocardium. Transient high-dose application of acetylcholine into the epicardial coronary arteries provides a unique opportunity to augment net outward current, selectively, in the ventricular epicardium and unmask the J wave, irrespective of the cardiac ischemia based on coronary spasm. Acetylcholine augments cardiac membrane potassium conductance by enhancing acetylcholine-activated potassium current directly and by activating adenosine triphosphate-sensitive potassium current, in addition to the reduced sodium and calcium currents in the setting of severe ischemia due to vasospasm. However, the role of acetylcholine as an arrhythmogenic probe of the J wave induction in patients with suspected early repolarization syndrome warrants future prospective study.
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17
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Seo J, Park J, Oh J, Uhm JS, Sung JH, Kim JY, Pak HN, Lee MH, Joung B. High Prevalence and Clinical Implication of Myocardial Bridging in Patients with Early Repolarization. Yonsei Med J 2017; 58:67-74. [PMID: 27873497 PMCID: PMC5122654 DOI: 10.3349/ymj.2017.58.1.67] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 05/30/2016] [Accepted: 05/30/2016] [Indexed: 01/29/2023] Open
Abstract
PURPOSE Recent evidence suggests that early repolarization (ER) is related with myocardial ischemia. Compression of coronary artery by a myocardial bridging (MB) can be associated with clinical manifestations of myocardial ischemia. This study aimed to evaluate the associations of MB in patients with ER. MATERIALS AND METHODS In consecutive patients (n=1303, age, 61±12 years) who had undergone coronary angiography, we assessed the prevalence and prognostic implication of MB in those with ER (n=142) and those without ER (n=1161). RESULTS MB was observed in 54 (38%) and 196 (17%) patients in ER and no-ER groups (p<0.001). In multivariate analysis, MB was independently associated with ER (odd ratio: 2.9, 95% confidence interval: 1.98-4.24, p<0.001). Notched type ER was more frequently observed in MB involving the mid portion of left anterior descending coronary artery (LAD) (69.8% vs. 30.2%, p=0.03). Cardiac event was observed in nine (6.3%) and 22 (1.9%) subjects with and without ER, respectively. MB was more frequently observed in sudden death patients with ER (2 out of 9, 22%) than in those without ER (0 out of 22). CONCLUSION MB was independently associated with ER in patients without out structural heart disease who underwent coronary angiography. Notched type ER was closely related with MB involving the mid portion of the LAD. Among patients who had experienced cardiac events, a higher prevalence of MB was observed in patients with ER than those without ER. Further prospective studies on the prognosis of MB in ER patients are required.
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Affiliation(s)
- Jiwon Seo
- Department of Internal Medicine, Division of Cardiology, Yonsei University College of Medicine, Seoul, Korea
| | - Junbeom Park
- Department of Internal Medicine, Division of Cardiology, Ewha Womans University, Seoul, Korea
| | - Jaewon Oh
- Department of Internal Medicine, Division of Cardiology, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Sun Uhm
- Department of Internal Medicine, Division of Cardiology, Yonsei University College of Medicine, Seoul, Korea
| | - Jung Hoon Sung
- Department of Internal Medicine, Division of Cardiology, Bundang CHA Medical Center, CHA University, Seongnam, Korea
| | - Jong Youn Kim
- Department of Internal Medicine, Division of Cardiology, Yonsei University College of Medicine, Seoul, Korea
| | - Hui Nam Pak
- Department of Internal Medicine, Division of Cardiology, Yonsei University College of Medicine, Seoul, Korea
| | - Moon Hyoung Lee
- Department of Internal Medicine, Division of Cardiology, Yonsei University College of Medicine, Seoul, Korea
| | - Boyoung Joung
- Department of Internal Medicine, Division of Cardiology, Yonsei University College of Medicine, Seoul, Korea.
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18
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Antzelevitch C, Yan GX, Ackerman MJ, Borggrefe M, Corrado D, Guo J, Gussak I, Hasdemir C, Horie M, Huikuri H, Ma C, Morita H, Nam GB, Sacher F, Shimizu W, Viskin S, Wilde AA. J-Wave syndromes expert consensus conference report: Emerging concepts and gaps in knowledge. J Arrhythm 2016; 32:315-339. [PMID: 27761155 PMCID: PMC5063270 DOI: 10.1016/j.joa.2016.07.002] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
| | - Gan-Xin Yan
- Lankenau Medical Center, Wynnewood, PA, United States
| | - Michael J. Ackerman
- Departments of Cardiovascular Diseases, Pediatrics, and Molecular Pharmacology & Experimental Therapeutics, Divisions of Heart Rhythm Services and Pediatric Cardiology, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, MN, United States
| | - Martin Borggrefe
- 1st Department of Medicine–Cardiology, University Medical Centre Mannheim, and DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Domenico Corrado
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy
| | - Jihong Guo
- Division of Cardiology, Peking University of People׳s Hospital, Beijing, China
| | - Ihor Gussak
- Rutgers University, New Brunswick, NJ, United States
| | - Can Hasdemir
- Department of Cardiology, Ege University School of Medicine, Izmir, Turkey
| | - Minoru Horie
- Shiga University of Medical Sciences, Ohtsu, Shiga, Japan
| | - Heikki Huikuri
- Research Unit of Internal Medicine, Medical Research Center, Oulu University Hospital, and University of Oulu, Oulu, Finland
| | - Changsheng Ma
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, China
| | - Hiroshi Morita
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Gi-Byoung Nam
- Heart Institute, Asian Medical Center, and Department of Internal Medicine, University of Ulsan College of Medicine Seoul, Seoul, South Korea
| | - Frederic Sacher
- Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Sami Viskin
- Tel-Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Arthur A.M. Wilde
- Heart Center, Department of Clinical and Experimental Cardiology, Academic Medical Center, University of Amsterdam, The Netherlands
- Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders, Jeddah, Saudi Arabia
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19
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Antzelevitch C, Yan GX, Ackerman MJ, Borggrefe M, Corrado D, Guo J, Gussak I, Hasdemir C, Horie M, Huikuri H, Ma C, Morita H, Nam GB, Sacher F, Shimizu W, Viskin S, Wilde AAM. J-Wave syndromes expert consensus conference report: Emerging concepts and gaps in knowledge. Heart Rhythm 2016; 13:e295-324. [PMID: 27423412 PMCID: PMC5035208 DOI: 10.1016/j.hrthm.2016.05.024] [Citation(s) in RCA: 226] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Indexed: 12/16/2022]
Affiliation(s)
| | - Gan-Xin Yan
- Lankenau Medical Center, Wynnewood, Pennsylvania
| | - Michael J Ackerman
- Departments of Cardiovascular Diseases, Pediatrics, and Molecular Pharmacology & Experimental Therapeutics, Divisions of Heart Rhythm Services and Pediatric Cardiology, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester,Minnesota
| | - Martin Borggrefe
- 1st Department of Medicine-Cardiology, University Medical Centre Mannheim, and DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Domenico Corrado
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy
| | - Jihong Guo
- Division of Cardiology, Peking University of People's Hospital, Beijing, China
| | - Ihor Gussak
- Rutgers University, New Brunswick, New Jersey
| | - Can Hasdemir
- Department of Cardiology, Ege University School of Medicine, Izmir, Turkey
| | - Minoru Horie
- Shiga University of Medical Sciences, Ohtsu, Shiga, Japan
| | - Heikki Huikuri
- Research Unit of Internal Medicine, Medical Research Center, Oulu University Hospital, and University of Oulu, Oulu, Finland
| | - Changsheng Ma
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, China
| | - Hiroshi Morita
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Gi-Byoung Nam
- Heart Institute, Asan Medical Center, and Department of Internal Medicine, University of Ulsan College of Medicine Seoul, Seoul, Korea
| | - Frederic Sacher
- Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Sami Viskin
- Tel-Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Arthur A M Wilde
- Heart Center, Department of Clinical and Experimental Cardiology, Academic Medical Center, University of Amsterdam, the Netherlands and Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders, Jeddah, Kingdom of Saudi Arabia
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20
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Liu T, Zheng J, Yan GX. J Wave Syndromes: History and Current Controversies. Korean Circ J 2016; 46:601-609. [PMID: 27721848 PMCID: PMC5054169 DOI: 10.4070/kcj.2016.46.5.601] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 03/14/2016] [Accepted: 03/17/2016] [Indexed: 11/11/2022] Open
Abstract
The concept of J wave syndromes was first proposed in 2004 by Yan et al for a spectrum of electrocardiographic (ECG) manifestations of prominent J waves that are associated with a potential to predispose affected individuals to ventricular fibrillation (VF). Although the concept of J wave syndromes is widely used and accepted, there has been tremendous debate over the definition of J wave, its ionic and cellular basis and arrhythmogenic mechanism. In this review article, we attempted to discuss the history from which the concept of J wave syndromes (JWS) is evolved and current controversies in JWS.
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Affiliation(s)
- Tong Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Jifeng Zheng
- Department of cardiology, The Second Hospital of Jiaxing, Jiaxing, China
| | - Gan-Xin Yan
- Lankenau Institute for Medical Research and Lankenau Medical Center, Wynnewood, Pennsylvania, USA.; The First Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, China
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21
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Rizzo C, Monitillo F, Iacoviello M. 12-lead electrocardiogram features of arrhythmic risk: A focus on early repolarization. World J Cardiol 2016; 8:447-455. [PMID: 27621772 PMCID: PMC4997525 DOI: 10.4330/wjc.v8.i8.447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 05/30/2016] [Accepted: 07/13/2016] [Indexed: 02/06/2023] Open
Abstract
The 12-lead electrocardiogram (ECG) is still the most used tool in cardiology clinical practice. Considering its easy accessibility, low cost and the information that it provides, it remains the starting point for diagnosis and prognosis. More specifically, its ability to detect prognostic markers for sudden cardiac death due to arrhythmias by identifying specific patterns that express electrical disturbances of the heart muscle, which may predispose to malignant arrhythmias, is universally recognized. Alterations in the ventricular repolarization process, identifiable on a 12-lead ECG, play a role in the genesis of ventricular arrhythmias in different cardiac diseases. The aim of this paper is to focus the attention on a new marker of arrhythmic risk, the early repolarization pattern in order to highlight the prognostic role of the 12-lead ECG.
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22
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The Osborn wave: what have we learned? Herz 2015; 41:48-56. [DOI: 10.1007/s00059-015-4338-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 06/22/2015] [Accepted: 06/29/2015] [Indexed: 11/28/2022]
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23
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Abstract
A prominent J wave is encountered in a number of life-threatening cardiac arrhythmia syndromes, including the Brugada syndrome and early repolarization syndromes. Brugada syndrome and early repolarization syndromes differ with respect to the magnitude and lead location of abnormal J waves and are thought to represent a continuous spectrum of phenotypic expression termed J-wave syndromes. Despite two decades of intensive research, risk stratification and the approach to therapy of these 2 inherited cardiac arrhythmia syndromes are still undergoing rapid evolution. Our objective in this review is to provide an integrated synopsis of the clinical characteristics, risk stratifiers, and molecular, ionic, cellular, and genetic mechanisms underlying these 2 fascinating syndromes that have captured the interest and attention of the cardiology community in recent years.
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Affiliation(s)
| | - Gan-Xin Yan
- Lankenau Institute for Medical Research and Lankenau Medical Center, Wynnewood, Pennsylvania; Jefferson Medical College, Philadelphia, Pennsylvania; The First Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, China
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24
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Tan VH, Duff H, Gerull B, Sumner G. Early repolarization syndrome: A case report focusing on dynamic electrocardiographic changes before ventricular arrhythmias and genetic analysis. HeartRhythm Case Rep 2015; 1:213-216. [PMID: 28491551 PMCID: PMC5419330 DOI: 10.1016/j.hrcr.2015.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Vern Hsen Tan
- Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada
- Cardiology Department, Changi General Hospital, Singapore
| | - Henry Duff
- Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada
- Cardiology Department, Changi General Hospital, Singapore
| | - Brenda Gerull
- Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada
| | - Glen Sumner
- Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada
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25
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Affiliation(s)
- Heikki V Huikuri
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
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