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Haïssaguerre M, Sellal JM, Benali K, de Becker B, Defaye P, Pascale P, Martins R, Mabo P, Xhaet O, Extramiana F, Surget E, Lavergne T, Marijon E, Adragao P, Carvalho MS, Milliez PU, Laredo M, Gandjbakhch E, Giustetto C, Gaita F, Tilz R, Jesel-Morel L, Steinfurt J, Arentz T, Knecht S, Duytschaever M, Roten L, Reichlin T, Fatemi M, Mansourati J, Kouakam C, Bessière F, Chevalier P, Tadros R, Macle L, Gallego F, Hadjis A, Sacher F, Pereira D, Hourdain J, Deharo JC, Eschalier R, Massoulié G, Maury P, Latcu DG, Anselme F, Duchateau J, Tixier R, Nademanee K, Nogami A, de Groot N, Vigmond E, Bernus O, Strik M, Bordachar P, Cathala A, Bouteiller X, Dubois R, Ploux S. Distinct Substrates of Idiopathic Ventricular Fibrillation Revealed by Arrhythmia Characteristics on Implantable Cardioverter-Defibrillator. JACC Clin Electrophysiol 2024:S2405-500X(24)00356-6. [PMID: 38970599 DOI: 10.1016/j.jacep.2024.04.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 04/25/2024] [Accepted: 04/27/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND Idiopathic ventricular fibrillation (IVF) can be associated with undetected distinct conditions such as microstructural cardiomyopathic alterations (MiCM) or Purkinje (Purk) activities with structurally normal hearts. OBJECTIVE This study sought to evaluate the characteristics of recurrent VF recorded on implantable defibrillator electrograms, associated with these substrates. METHODS This was a multicenter collaboration study. At 32 centers, we selected patients with an initial diagnosis of IVF and recurrent arrhythmia at follow-up without antiarrhythmic drugs, in whom mapping demonstrated Purk or MiCM substrate. We analyzed variables related to previous ectopy, sinus rate preceding VF, trigger, and initial VF cycle lengths. Logistic regression with cross validation was used to evaluate the performance of criteria to discriminate Purk or MiCM substrates. RESULTS Among 95 patients (35 women, age 35 ± 11 years) meeting the inclusion criteria, IVF was associated with MiCM in 41 and Purk in 54 patients. A total of 117 arrhythmia recurrences including 91% VF were recorded on defibrillator. Three variables were mostly discriminant. Sinus tachycardia (≤570 ms) was more frequent in MiCM (35.9% vs 13.4%, P = 0.014) whereas short-coupled (<350 ms) triggers were most frequent in Purk-related VF (95.5% vs 23.1%, P = 0.001), which also had shorter VFCLs (182 ± 15 ms vs 215 ± 24 ms, P < 0.001).The multivariable combination provided the highest prediction (accuracy = 0.93 ± 0.05, range 0.833-1.000), discriminating 81% of IVF substrates with a high probability (>80%). Ectopy were inconsistently present before VF. CONCLUSIONS Characteristics of arrhythmia recurrences on implantable cardioverter- defibrillator provide phenotypic markers of the distinct and hidden substrates underlying IVF. These findings have significant clinical and genetic implications.
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Affiliation(s)
- Michel Haïssaguerre
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux Université, Bordeaux, France; Cardiac electrophysiology and stimulation, Cardiology Department, Bordeaux University Hospital (CHU), Pessac, France.
| | - Jean-Marc Sellal
- Cardiology Department, Nancy University Hospital (CHRU), Nancy, France
| | - Karim Benali
- Cardiac electrophysiology and stimulation, Cardiology Department, Bordeaux University Hospital (CHU), Pessac, France; Department of Cardiac Electrophysiology, Saint-Etienne University Hospital Center, Jean-Monnet University, Saint-Etienne, France
| | | | - Pascal Defaye
- Rhythmology and Cardiac stimulation Unit, Grenoble University Hospital (CHU), Grenoble, France
| | - Patrizio Pascale
- Cardiology Department, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Raphael Martins
- Cardiology Department, Rennes University Hospital (CHU), Rennes, France
| | - Philippe Mabo
- Cardiology Departement, Namur University Hospital (CHU UCL Namur), Yvoir, Belgium
| | - Olivier Xhaet
- Cardiology Department, APHP Hôpital Bichat, Paris, France
| | - Fabrice Extramiana
- Cardiology Department, Rhythmology Unit, Hôpital Européen Georges Pompidou, Paris, France
| | - Elodie Surget
- Heart Rhythm Centre, Hospital da Luz, Lisbon, Portugal
| | - Thomas Lavergne
- Cardiology Department, Caen Normandie University Hospital (CHU), Caen, France
| | - Eloi Marijon
- Pitié-Salpêtrière University Hospital, Institute of Cardiology, Paris, France
| | - Pedro Adragao
- Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Paul-Ursmar Milliez
- Cardiology Department, Caen Normandie University Hospital (CHU), Caen, France
| | - Mickael Laredo
- Pitié-Salpêtrière University Hospital, Institute of Cardiology, Paris, France
| | - Estelle Gandjbakhch
- Pitié-Salpêtrière University Hospital, Institute of Cardiology, Paris, France
| | - Carla Giustetto
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Fiorenzo Gaita
- Universitätsklinikum Schleswig-Holstein (UKSH), Klinik für Rhythmologie, Lübeck, Germany
| | - Roland Tilz
- Cardiology Department, Strasbourg University Hospital (CHRU), Strasbourg, France
| | - Laurence Jesel-Morel
- Cardiology Department, Strasbourg University Hospital (CHRU), Strasbourg, France
| | - Johannes Steinfurt
- Department of Cardiology, Universitäts-Herzzentrum Freiburg - Bad Krozingen, Freiburg, Germany
| | - Thomas Arentz
- Department of Cardiology, Universitäts-Herzzentrum Freiburg - Bad Krozingen, Freiburg, Germany
| | | | | | - Laurent Roten
- Inselspital, Bern University Hospital, University Clinic for Cardiology, Bern, Switzerland
| | - Tobias Reichlin
- Inselspital, Bern University Hospital, University Clinic for Cardiology, Bern, Switzerland
| | - Marjaneh Fatemi
- Cardiology Department, Brest University Hospital(CHU), Brest, France
| | | | - Claude Kouakam
- Cardiology Department, Lille University Hospital (CHRU), Lille, France
| | - Francis Bessière
- Cardiac Rhythmology Department, Hôpital cardiologique Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - Philippe Chevalier
- Cardiac Rhythmology Department, Hôpital cardiologique Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - Rafik Tadros
- Montreal Heart Institute (ICM), Montréal, Canada
| | | | | | - Alexios Hadjis
- Electrophysiology Unit, Cardiology Department, Sacré-Coeur Hospital of Montréal (HSCM), Montréal, Canada
| | - Frederic Sacher
- Cardiac electrophysiology and stimulation, Cardiology Department, Bordeaux University Hospital (CHU), Pessac, France; Reference Center for Hereditary Rhythmic Diseases and Sudden Death Prevention (CMARY), Cardiology Department, Bordeaux University Hospital (CHU), Pessac, France
| | - Dylan Pereira
- Cardiology Department, Tours University Hospital (CHU), Tours, France
| | - Jerome Hourdain
- Cardiology Department, Tours University Hospital (CHU), Tours, France
| | - Jean-Claude Deharo
- Cardiology Department, Marseille University Hospital La Timone (AP-HM), Marseille, France
| | - Romain Eschalier
- Cardiology Department, Marseille University Hospital La Timone (AP-HM), Marseille, France; Cardiology Department, Clermont-Ferrand University Hospital, (CHU), Clermont-Ferrand, France
| | - Grégoire Massoulié
- Cardiology Department, Clermont-Ferrand University Hospital, (CHU), Clermont-Ferrand, France
| | - Philippe Maury
- Cardiology Department, Rangueil University Hospital (CHU), Toulouse, France
| | | | - Frederic Anselme
- Cardiology Department, Rouen-Normandie University Hospital (CHU), Rouen, France
| | - Josselin Duchateau
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux Université, Bordeaux, France; Cardiac electrophysiology and stimulation, Cardiology Department, Bordeaux University Hospital (CHU), Pessac, France
| | - Romain Tixier
- Cardiac electrophysiology and stimulation, Cardiology Department, Bordeaux University Hospital (CHU), Pessac, France
| | - Koonlawee Nademanee
- Pacific Rim Electrophysiology Research Institute at Bumrungrad Hospital, Bangkok, Thailand
| | | | | | - Edward Vigmond
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux Université, Bordeaux, France
| | - Olivier Bernus
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux Université, Bordeaux, France
| | - Marc Strik
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux Université, Bordeaux, France; Cardiac electrophysiology and stimulation, Cardiology Department, Bordeaux University Hospital (CHU), Pessac, France
| | - Pierre Bordachar
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux Université, Bordeaux, France; Cardiac electrophysiology and stimulation, Cardiology Department, Bordeaux University Hospital (CHU), Pessac, France
| | - Aude Cathala
- Cardiac electrophysiology and stimulation, Cardiology Department, Bordeaux University Hospital (CHU), Pessac, France
| | - Xavier Bouteiller
- Cardiac electrophysiology and stimulation, Cardiology Department, Bordeaux University Hospital (CHU), Pessac, France
| | - Remi Dubois
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux Université, Bordeaux, France
| | - Sylvain Ploux
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux Université, Bordeaux, France; Cardiac electrophysiology and stimulation, Cardiology Department, Bordeaux University Hospital (CHU), Pessac, France
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Kim J, Choi J, Shin MS, Park JK, An M, Kim SH, Choi N, Lee MO, Heo S. Effect of physical and psychocognitive function and perceived health status on 12-month adverse cardiac events among implantable cardioverter-defibrillator recipients. Heart Lung 2020; 49:530-536. [PMID: 32434703 DOI: 10.1016/j.hrtlng.2020.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/31/2020] [Accepted: 04/13/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Post-implant recovery in patients with implantable cardioverter-defibrillators (ICDs) is often compromised because of reduced physical and psycho-cognitive function and poor health perception, leading to short event-free survival. OBJECTIVES To examine the effects of psychocognitive function, health perception, and ICD-related factors on 12-month cardiac events among ICD patients. METHODS Using a prospective study design, ICD patients underwent baseline assessment and were followed for 12 months to assess cardiac events. RESULTS Cardiac events occurred in 14 patients (18.9%) (N = 74: age, 58 years; primary ICDs, 45.9%). Time after ICD implant (odds ratio [OR] = 1.002; p = .028) and executive function (OR = 1.021; p = .027) were significant predictors of 12-month cardiac events, while other physical and psychological indices were not. CONCLUSIONS Reduced executive function and longer time after implant predicted the events. Healthcare professionals need to assess executive function and provide treatment and support to improve executive function.
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Affiliation(s)
- JinShil Kim
- Gachon University, College of Nursing, Incheon, South Korea
| | - Jiin Choi
- Office of Hospital Information, Seoul National University Hospital, Seoul, South Korea
| | - Mi-Seung Shin
- Division of Cardiology, Department of Internal Medicine, Gil Medical Center, Gachon University, College of Medicine, Incheon, South Korea
| | - Jin-Kyu Park
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University Medical Center, Seoul, South Korea
| | - Minjeong An
- Chonnam National University, College of Nursing, Gwangju, South Korea
| | - Sun Hwa Kim
- Department of Nursing, Hanyang University Medical Center, Seoul, South Korea.
| | - Nayeon Choi
- Biostatistical Consulting and Research Lab, Medical Research Collaborating Center, Hanyang University, Seoul, Korea
| | - Mee Ok Lee
- Gachon University Gil Medical Center, Incheon, South Korea
| | - Seongkum Heo
- Mercer University, Georgia Baptist College of Nursing, Atlanta, USA
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