Left ventricular dysfunction is associated with prolonged average ventricular fibrillation cycle length in patients with implantable cardioverter defibrillators

Left ventricular dysfunction is associated with prolonged average ventricular fibrillation cycle length in patients with implantable cardioverter defibrillators

Autor Fenelon, G. Google Scholar
Stambler, B. S. Google Scholar
Huvelle, E. Google Scholar
Brugada, P. Google Scholar
Stevenson, W. G. Google Scholar
European VENTAK MINI Investigator Google Scholar
Instituição Brigham & Womens Hosp
Harvard Univ
Guidant Europe
Ctr Cardiovasc
Universidade Federal de São Paulo (UNIFESP)
Resumo Objectives: in cellular studies, ventricular refractoriness (ERP) is prolonged in heart failure (CHF), but clinical evidence is lacking. the average ventricular fibrillation cycle length (VFCL) has been shown to correlate with local ERP. We hypothesized that the VFCL increases with left ventricular (LV) dysfunction. Therefore, we evaluated intracardiac VFCL recorded by implantable defibrillators (ICD) in patients with and without LV dysfunction.Methods: We analyzed intracardiac VFCL recorded by sensing leads of Ventak MINI ( Guidant) ICD in 49 patients ( 35 men; age 54 +/- 13 years; 25 (51%) with coronary artery disease; mean LV ejection fraction (EF) 41 +/- 17%, range 76-10) from the European Ventak MINI Investigator Group. No patients were receiving antiarrhythmic drugs, including beta-blockers. Mean and median VFCL were obtained at predischarge testing during first charge time (4.5 +/- 2.7 s, range 1.4-11).Results: Mean median VFCL was 186 +/- 21ms ( range 150 - 230 ms). Patients with LVEF greater than or equal to 50% ( n= 14) had shorter median VFCL than patients with LVEF< 50% (n= 35), (171 +/- 14 vs. 191 +/- 20 ms; p= 0.002). Median VFCL correlated with LVEF ( r=- 0.41; p= 0.003) and age ( r= 0.28, p= 0.04), but was not significantly associated with charge time and defibrillation threshold at implant. Similar results occurred with mean VFCL. in multiple linear regression and correlation models, only LVEF% was a significant predictor ( p< 0.05 for all models) of median VFCL.Conclusions: LV dysfunction prolongs averaged VFCL in patients at risk for malignant ventricular arrhythmias who have implantable cardioverter defibrillators. This phenomenon might be related to alterations in the ventricular refractory period.
Palavra-chave implantable cardioverter defibrillator
heart failure
sudden-death
ventricular fibrillation
Idioma Inglês
Data de publicação 2002-12-01
Publicado em Journal of Interventional Cardiac Electrophysiology. Dordrecht: Springer, v. 7, n. 3, p. 249-254, 2002.
ISSN 1383-875X (Sherpa/Romeo, fator de impacto)
Publicador Springer
Extensão 249-254
Fonte http://dx.doi.org/10.1023/A:1021393525558
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000179641600007
Endereço permanente http://repositorio.unifesp.br/handle/11600/27066

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