2011 Volume 27 Issue Supplement Pages PE3_021
Introduction: Although idiopathic ventricular fibrillation (IVF) with early repolarization (ER) has been reported, ER is a common finding in healthy subjects and also found in Wolff-Parkinson-White (WPW) syndrome. To clarify the mechanisms of ER, we assessed rate dependent changes in ER. Methods: Eight IVF patients and 20 healthy controls with J-wave elevation (JWE) in lateral leads were studied. Among 111 patients with WPW syndrome, 28 with persistent JWE in lateral leads before and after catheter ablation (CA) were also recruited. J/RR relationship was evaluated using CM-5 lead 24-hour Holter ECG. Results: From J-RR liner regression lines, the J-RR slope (mm/sec) was greater in both IVF patients and patients with WPW syndrome than controls (3.7±2.2 and 3.5±0.8 vs 2.2±0.7, p<0.01). J-wave at RR interval of 0.6 sec (J(0.6)) wasn’t different between 3 groups; however, J(1.2) (mm) was greater in IVF patients than controls (2.8±0.9 vs 2.0±0.6, p<0.05). In patients with WPW syndrome, J-RR slope decreased to the similar extent to the controls after successful CA. Conclusions: In IVF patients, bradycardia-dependent augmentation of JWE could be related to nighttime occurrence of VF. Similar bradycardia-dependent augmentation of JWE was demonstrated before CA and was attenuated after CA in patients with WPW syndrome. Hence, JWE may be partly related to early depolarization through the accessory pathway, but other mechanisms could be involved in WPW syndrome.
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