Abstract 13802: J Waves Observed in More Than 3 Electrocardiographic Leads Predict the Presence of Organized Myocardial Fibrotic or Fat Change in Non Ischemic Survivors of Ventricular Fibrillation

Abstract

Introduction: The distribution of J waves and the presence of organized left ventricular (LV) myocardial damage may be related in non ischemic survivors of ventricular fibrillation (VF). Hypothesis: We hypothesize that the distribution of J waves can predict the presence of myocardial damage such as fibrotic or fat change in non ischemic survivors of VF. Methods: We conducted a retrospective analysis of 16 survivors of VF (12 males; 60±15 years) without any histories of previous myocardial infarction and underwent cardiac CT in which no significant coronary stenosis were observed and/or MRI before implantation of a cardioverter defibrillator. Results: On ECG, 3 patients had atrial fibrillation and 12 had J waves. On CT and/or MRI, 7 patients had organized LV myocardial fibrotic and/or fat change. The mean corrected QT interval was 451±47 and 415±5 msec in patients with and without J waves (P=0.147) and 458±32 and 429±48 msec in patients with and without myocardial fibrotic and/or fat change (P=0.202), respectively. The distribution of J waves was presented in the table. Presence of the J waves observed more than 3 ECG leads (N=4) and presence of myocardial fibrotic and/or fat change (N=7) significantly correlated each other in the Fisher's exact test (P=0.019). Presence of myocardial fibrotic and/or fat change were significantly greater in patients with J waves observed more than 3 ECG leads than those with J waves observed less than 4 ECG leads (100% vs 25%, P=0009). Presence of J waves observed more than 3 ECG leads were also significantly greater in patients with myocardial fibrotic and/or fat change than those without (57% vs 0%, P=0009). Conclusions: In non ischemic survivors of VF, if J waves were observed more than 3 ECG leads, the frequency of LV myocardial fibrotic and/or fat change was significantly higher than those without. The distribution and numbers of ECG leads with J waves and the presence of myocardial fibrotic and/or fat change may be useful to predict non ischemic VF.