Open AccessClinical valuation of ST changes in a group of patients with ventricular arrhythmias: The inSighT Study
Author(s) -
Wranicz Jerzy Krzysztof,
Kałowski Michał,
Bastian Dirk,
Jaswal Aparna,
Kolb Christof,
Zitron Edgar,
Cygankiewicz Iwona,
Kaczmarek Krzysztof
Publication year - 2022
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.12914
Subject(s) - medicine , cardiology , coronary artery disease , implantable cardioverter defibrillator , st segment , benign early repolarization , myocardial infarction
Background The inSighT study was designed to determine the prevalence of ischemic changes as recorded by implantable cardioverter–defibrillator (ICD) ST deviations in intracardiac electrocardiograms (EGM) over the 24 h preceding malignant ventricular arrhythmias (VT/VF). Methods The study enrolled patients with known coronary artery disease (CAD) or high risk of future development of CAD implanted with an ICD equipped with an ST monitoring feature (Ellipse™/Fortify Assura™, St. Jude Medical). Device session records were collected at each in‐clinic follow‐up. EGM ST levels of the beats over the 15 minutes prior to VT/VF events were compared using a t test with those from a baseline period of 23–24 h prior to the VT/VF event. All events with p < .05 were visually inspected to confirm they were evaluable; additional criteria for exclusion from further analysis included inappropriate therapy, aberrant conduction, and occurrence of VT/VF within 24h prior to the current event. Results The study enrolled 481 ICD patients (64 ± 11 years, 83% male) in 14 countries and followed them for 15±5 months. A total of 165 confirmed VT/VF episodes were observed, of which 71 events (in 56 patients, 34% of all patients with VT/VF) were preceded by significant ( p < .05) ST‐segment changes unrelated to known non‐ischemic causes. None of the analyzed demographic and clinical factors proved to be associated with greater odds of presenting with ST‐segment changes prior to VT/VF episode. Conclusion In this exploratory study, characteristic ST‐segment changes, likely representative of ischemic events, were observed in 34% of all patients with VT/VF episodes.