Presence of myocardial fibrotic or fat change on cardiac CT influences the width of distribution range of J waves in survivors of ventricular fibrillation

Abstract

Abstract Background The distribution of J waves may correlate with left ventricular (LV) myocardial damage in survivors of ventricular fibrillation (VF). Purpose To determine the relationship of the distribution of J waves with presence of myocardial damage such as fibrotic or fat change 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, 4 patients had atrial fibrillation and 15 had J waves. On CT, 13 patients had organized LV myocardial fibrotic and/or fat change in myocardium. The mean corrected QT interval was 453±30 and 429±48 msec in patients with and without myocardial fibrotic and/or fat change, respectively (P=0.182). The distribution of J waves was as follows: 5 had J waves in II, III and aVF leads (one had myocardial fibrotic and/or fat change) and 2 had J waves in III lead (one had myocardial fibrotic and/or fat change). One patient each had J waves in V1 lead; V1,2 leads; II, III, aVF and V1–3 leads; I, III, aVF and V1 leads; II, III, aVF, aVL and V1–6 leads; II, III, aVF and V4,5 leads; II, III, aVF and V2–5 leads; and III and aVF leads. The first one did not have myocardial fibrotic and/or fat change and the remaining 6 had myocardial fibrotic and/or fat change (Figure). If the J waves reached to ≥1 of 3 LV inferior wall leads (II, III, aVF leads) (N=13), 10 (77%) had LV myocardial fibrotic and/or fat change. If not (N=8), 3 (38%) had LV myocardial fibrotic and/or fat change (P=0.071). If the J waves reached ≥2 of 3 LV inferior wall leads (N=11), 9 (82%) had LV myocardial fibrotic and/or fat change. If not (N=10), 4 (40%) had LV myocardial fibrotic and/or fat change (P=0.049). If the J waves reached all three LV inferior wall leads (N=10), 8 (80%) had LV myocardial fibrotic and/or fat change. If not (N=11), 5 (46%) had LV myocardial fibrotic and/or fat change (P=0.104). Conclusions In survivors of VF, organized LV myocardial fibrotic and/or fat changes on cardiac CT correlate with a wider distribution range of J waves (reached to LV inferior wall leads). The distribution of J waves and the presence of myocardial fibrotic and/or fat change on CT may be useful to predict the occurrence of VF. Funding Acknowledgement Type of funding sources: None. CT fibrosis in VF survivorsJ waves and fibrotic and/or fat change