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Article Dans Une Revue Journal of the American College of Cardiology Année : 2015

Role of electrophysiological studies in predicting risk of ventricular arrhythmia in early repolarization syndrome.

Saagar Mahida
  • Fonction : Auteur
Nicolas Derval
  • Fonction : Auteur
Frederic Sacher
  • Fonction : Auteur
Isabel Deisenhofer
  • Fonction : Auteur
Jürg Schläpfer
  • Fonction : Auteur
Luc de Roy
  • Fonction : Auteur
Sinikka Yli-Mayry
  • Fonction : Auteur
Thomas Rostock
  • Fonction : Auteur
Akihiko Nogami
  • Fonction : Auteur
Josef Kautzner
  • Fonction : Auteur
Benjamin Berte
  • Fonction : Auteur
  • PersonId : 773824
  • IdRef : 189801298
Seigo Yamashita
  • Fonction : Auteur
Laurent Roten
  • Fonction : Auteur
Han S Lim
  • Fonction : Auteur
Arnaud Denis
  • Fonction : Auteur
Pierre Bordachar
  • Fonction : Auteur
Philippe Ritter
  • Fonction : Auteur
Mélèze Hocini
  • Fonction : Auteur
Pierre Jaïs
  • Fonction : Auteur
Michel Haïssaguerre
  • Fonction : Auteur

Résumé

Background - The early repolarization (ER) pattern is associated with an increased risk of arrhythmogenic sudden death. However, strategies for risk stratification of patients with the ER pattern are not fully defined. Objectives - This study sought to determine the role of electrophysiology studies (EPS) in risk stratification of patients with ER syndrome. Methods - In a multicenter study, 81 patients with ER syndrome (age 36 ± 13 years, 60 males) and aborted sudden death due to ventricular fibrillation (VF) were included. EPS were performed following the index VF episode using a standard protocol. Inducibility was defined by the provocation of sustained VF. Patients were followed up by serial implantable cardioverter-defibrillator interrogations. Results - Despite a recent history of aborted sudden death, VF was inducible in only 18 of 81 (22%) patients. During follow-up of 7.0 ± 4.9 years, 6 of 18 (33%) patients with inducible VF during EPS experienced VF recurrences, whereas 21 of 63 (33%) patients who were noninducible experienced recurrent VF (p = 0.93). VF storm occurred in 3 patients from the inducible VF group and in 4 patients in the noninducible group. VF inducibility was not associated with maximum J-wave amplitude (VF inducible vs. VF noninducible; 0.23 ± 0.11 mV vs. 0.21 ± 0.11 mV; p = 0.42) or J-wave distribution (inferior, odds ratio [OR]: 0.96 [95% confidence interval (CI): 0.33 to 2.81]; p = 0.95; lateral, OR: 1.57 [95% CI: 0.35 to 7.04]; p = 0.56; inferior and lateral, OR: 0.83 [95% CI: 0.27 to 2.55]; p = 0.74), which have previously been demonstrated to predict outcome in patients with an ER pattern. Conclusions - Our findings indicate that current programmed stimulation protocols do not enhance risk stratification in ER syndrome.

Dates et versions

hal-01141057 , version 1 (10-04-2015)

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Saagar Mahida, Nicolas Derval, Frederic Sacher, Antoine Leenhardt, Isabel Deisenhofer, et al.. Role of electrophysiological studies in predicting risk of ventricular arrhythmia in early repolarization syndrome.. Journal of the American College of Cardiology, 2015, 65 (2), pp.151-9. ⟨10.1016/j.jacc.2014.10.043⟩. ⟨hal-01141057⟩
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