Open AccessJ point elevation in high precordial leads associated with risk of ventricular fibrillation
Author(s) -
Hasegawa Yuki,
Watanabe Hiroshi,
Ikami Yasuhiro,
Otsuki Sou,
Iijima Kenichi,
Yagihara Nobue,
Izumi Daisuke,
Minamino Tohru
Publication year - 2021
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/anec.12820
Subject(s) - medicine , intercostal space , ventricular fibrillation , brugada syndrome , cardiology , st elevation , j wave , intercostal muscle , electrocardiography , surgery , respiratory system
The significance of high precordial electrocardiograms in idiopathic ventricular fibrillation (IVF) is unknown. Method This study included 50 consecutive patients (48 men; age, 42 ± 18 years) who had spontaneous ventricular fibrillation not linked to structural heart disease and received implantable cardiac defibrillator therapy. IVF was diagnosed in 35 patients and Brugada syndrome was diagnosed in other 15 patients. Electrocardiograms in high intercostal space were compared between 35 patients with IVF and 105 age‐ and sex‐matched healthy controls (patient: control ratio, 1:3). Results The frequency of J point elevation ≥ 0.1 mV in the 4th intercostal spaces was similar between patients with IVF (14%) and healthy controls (7%). However, the frequency of J point elevation ≥ 0.1 mV in the 3rd intercostal space was higher in patients with IVF (40%) than controls (11%) ( p < .01). J point elevation was present only in the 3rd intercostal space but not in the 4th intercostal space in 30% of patients with IVF but only in 6% of controls ( p < .01). During follow‐up, the recurrence of ventricular fibrillation was higher in patients with IVF who had J point elevation in the 3rd intercostal space (36%) and Brugada syndrome(40%) than those with IVF who did not have J point elevation in the 3rd intercostal space(11%) ( p < .05 for both). Conclusion J point elevation in the 3rd intercostal space was associated with IVF and recurrences of ventricular fibrillation. Electrocardiogram recordings in the high intercostal space may be useful to identify risk of sudden death.