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Naruse Y, de Riva M, Watanabe M, et al. The prognostic value of J-wave pattern for recurrence of ventricular tachycardia after catheter ablation in patients with myocardial infarction. Pacing Clin Electrophysiol. 2021;44(4):657-666doi: 10.1111/pace.14203.
Naruse, Y., de Riva, M., Watanabe, M., Wijnmaalen, A. P., Venlet, J., Timmer, M., Schalij, M. J., & Zeppenfeld, K. (2021). The prognostic value of J-wave pattern for recurrence of ventricular tachycardia after catheter ablation in patients with myocardial infarction. Pacing and clinical electrophysiology : PACE, 44(4), 657-666. https://doi.org/10.1111/pace.14203
Naruse, Yoshihisa, et al. "The prognostic value of J-wave pattern for recurrence of ventricular tachycardia after catheter ablation in patients with myocardial infarction." Pacing and clinical electrophysiology : PACE vol. 44,4 (2021): 657-666. doi: https://doi.org/10.1111/pace.14203
Naruse Y, de Riva M, Watanabe M, Wijnmaalen AP, Venlet J, Timmer M, Schalij MJ, Zeppenfeld K. The prognostic value of J-wave pattern for recurrence of ventricular tachycardia after catheter ablation in patients with myocardial infarction. Pacing Clin Electrophysiol. 2021 Apr;44(4):657-666. doi: 10.1111/pace.14203. Epub 2021 Mar 09. PMID: 33624326; PMCID: PMC8252510.
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Pacing Clin Electrophysiol. 2021 Apr;44(4):657-666. doi: 10.1111/pace.14203. Epub 2021 Mar 09.

The prognostic value of J-wave pattern for recurrence of ventricular tachycardia after catheter ablation in patients with myocardial infarction.

Pacing and clinical electrophysiology : PACE

Yoshihisa Naruse, Marta de Riva, Masaya Watanabe, Adrianus P Wijnmaalen, Jeroen Venlet, Marnix Timmer, Martin J Schalij, Katja Zeppenfeld

Affiliations

  1. Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.

PMID: 33624326 PMCID: PMC8252510 DOI: 10.1111/pace.14203

Abstract

BACKGROUND: J-waves and fragmented QRS (fQRS) on surface ECGs have been associated with the occurrence of ventricular tachyarrhythmias. Whether these non-invasive parameters can also predict ventricular tachycardia (VT) recurrence after radiofrequency catheter ablation (RFCA) is unknown. Of interest, patients with a wide QRS-complex have been excluded from clinical studies on J-waves, although a J-wave like pattern has been described for wide QRS.

METHODS: We retrospectively included 168 patients (67 ± 10 years; 146 men) who underwent RFCA of post-infarct VT. J-wave pattern were defined as J-point elevation ≥ 0.1 mV in at least two leads irrespective of QRS width. fQRS was defined as various RSR` pattern in patients with narrow QRS and more than two R wave in those with wide QRS. The primary endpoint was VT recurrence after RFCA up to 24 months.

RESULTS: J-wave pattern and fQRS were present in 27 and 28 patients, respectively. Overlap of J-wave pattern and fQRS was observed in nine. During a median follow-up of 20 (interquartile range 9-24) months, 46 (27%) patients had VT recurrence. Kaplan-Meier curves revealed that both J-wave pattern and fQRS were associated with VT recurrence. Multivariate Cox regression analysis demonstrated that the presence of J-wave pattern (hazard ratio [HR] 2.84; 95% confidence interval [CI] 1.45-5.58; P = .002) and greater number of induced VT (HR 1.29; 95% CI 1.15-1.45; P < .001) were the independent predictors of VT recurrence.

CONCLUSIONS: A J-wave pattern-but not fQRS-is independently associated with an increased risk of post-infarct VT recurrence after RFCA irrespective of QRS width. This simple non-invasive parameter may identify patients who require additional treatment.

© 2021 The Authors. Pacing and Clinical Electrophysiology published by Wiley Periodicals LLC.

Keywords: J-waves; fragmented QRS; myocardial infarction; radiofrequency catheter ablation; ventricular tachycardia

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