Frequency and distribution of J waves in survivors of ventricular fibrillation relationship with presence of myocardial fibrotic and or fat change and coronary arterial stenosis on cardiac CT

Abstract

Abstract Background The presence and distribution of J waves, the occurrence of ventricular fibrillation (VF), and the presence of left ventricular (LV) myocardial fibrotic or fat change or coronary stenosis may be related. Purpose To determine the relationship of frequency and distribution of J waves with presence of myocardial fibrotic or fat change and coronary arterial stenosis on cardiac computed tomography (CT) in survivors of VF. Methods We conducted a retrospective analysis of 21 survivors of VF (17 males; mean age, 61±14 years) that were implanted with a cardioverter defibrillator and underwent cardiac CT. Results On ECG, four subjects had atrial fibrillation. The mean corrected QT interval was 442±39 msec. On CT, two subjects had significant coronary artery stenosis and 12 had LV myocardial fibrotic and/or fat change. The distribution of J waves were as follows: five subjects had J waves in II, III and aVF leads (three had myocardial fibrotic and/or fat change); and 2 had J waves in III lead (one had myocardial fibrotic and/or fat change). One subject each had J waves in V1 lead; V1, 2 leads; II, III, aVF and V1 leads; II, III, aVF and V1–3 leads; II, III, aVF, aVL and V1–6 leads; II, III, aVF and V1–6 leads; II, III, aVF and V4,5 leads; II, III, aVF and V2–5 leads; and III and aVF leads, respectively. The first two subjects did not have LV myocardial fibrotic and/or fat change and the remaining six subjects had myocardial fibrotic and/or fat change (Figure). Conclusions Survivors of VF with organized LV myocardial fibrotic and/or fat change showed more frequent J waves with a wider distribution (reached LV inferior wall leads) than survivors without these changes. Monitoring these characteristics on CT may be useful to predict VF. Funding Acknowledgement Type of funding sources: None. CT images of fat in a VF survivorJ waves and fibrotic and/or fat change