Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843

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QRS Prolongation is Associated With High Defibrillation Thresholds During Cardioverter-Defibrillator Implantations in Patients With Hypertrophic Cardiomyopathy
Takayuki NagaiTakashi KuritaKazuhiro SatomiTakashi NodaHideo OkamuraWataru ShimizuKazuhiro SuyamaNaohiko AiharaJunjiro KobayashiShiro Kamakura
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ジャーナル フリー 早期公開

論文ID: CJ-08-0744

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Background: Although high defibrillation threshold (DFT) is a major and unavoidable clinical problem after implantation of an implantable cardioverter defibrillator (ICD), little is known about the cause and management of a high DFT in patients with hypertrophic cardiomyopathy (HCM). The purpose of this study was to assess the predictors of a high DFT in patients with HCM. Methods and Results: Twenty-three patients with non-dilated HCM who underwent ICD implantation were included. The DFT at the time of the device implantation was measured in all patients. The patients were divided into 2 groups, a high DFT group (DFT ≥15J, n=13) and a low DFT group (DFT <15J, n=10); and their baseline characteristics were compared. The QRS duration was longer in the high than in the low DFT group (128 ±31 vs 103 ±12 ms, respectively; P=0.02). QRS duration, left ventricular (LV) end-systolic diameter, and LV ejection fraction were significant predictors of DFT in univariate analysis. However, in multivariate analysis, the only factor significantly associated with DFT was QRS duration (P=0.002). Conclusions: QRS duration is the most consistent predictor of a high DFT in HCM patients undergoing ICD implantation.
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© 2009 THE JAPANESE CIRCULATION SOCIETY
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