Heterogeneous response of J-wave syndromes to beta-adrenergic stimulation

Background Inferolateral early repolarization (ER) and Brugada syndrome manifest with J waves. Isoproterenol suppresses recurrent ventricular arrhythmias while reducing J waves in both disorders. Objective To characterize the effect of isoproterenol on J waves. Methods We analyzed the impact of isop...

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Veröffentlicht in:	Heart rhythm 2012-12, Vol.9 (12), p.1970-1976
Hauptverfasser:	Roten, Laurent, MD, Derval, Nicolas, MD, Sacher, Frédéric, MD, Pascale, Patrizio, MD, Scherr, Daniel, MD, Komatsu, Yuki, MD, Ramoul, Khaled, MD, Daly, Matthew, MD, Denis, Arnaud, MD, Shah, Ashok J., MD, Hocini, Mélèze, MD, Jaïs, Pierre, MD, Haïssaguerre, Michel, MD
Format:	Artikel
Sprache:	eng
Schlagworte:	Adrenergic beta-Agonists - administration & dosage Adult Beta-adrenergic stimulation Brugada syndrome Brugada Syndrome - drug therapy Brugada Syndrome - physiopathology Cardiovascular Early repolarization Electrocardiography - drug effects Female Follow-Up Studies Heart Rate - drug effects Humans Isoproterenol Isoproterenol - administration & dosage J wave Male QRS duration Signal-averaged ECG Treatment Outcome
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Zusammenfassung:	Background Inferolateral early repolarization (ER) and Brugada syndrome manifest with J waves. Isoproterenol suppresses recurrent ventricular arrhythmias while reducing J waves in both disorders. Objective To characterize the effect of isoproterenol on J waves. Methods We analyzed the impact of isoproterenol on J waves in 20 patients with Brugada-type electrocardiogram (Br group) and 38 patients with ER (ER group). Results In the ER group, J waves were present in inferior leads in 32 patients (84%) and in lateral leads in 23 patients (61%). Isoproterenol increased the heart rate by 75 beats/min in the ER group and by 71 beats/min in the Br group ( P = .20). The incidences of persistent (≤0.05-mV decrease), decreased, and normalized J waves (residual J wave ≤0.05 mV) were 20%, 80%, and 0% for Br group patients and 29%, 8%, and 63% for ER group patients, respectively ( P
ISSN:	1547-5271 1556-3871
DOI:	10.1016/j.hrthm.2012.08.003