Ventricular fibrillation waveform characteristics of the surface ECG: Impact of the left ventricular diameter and mass

RESUSCITATION

卷:115

Article

Bonnes, Judith L.¹  Thannhauser, Jos¹  Nas, Joris¹  Westra, Sjoerd W.¹  Jansen, Rutger M. G.²  Meinsma, Gjerrit³  de Boer, Menko-Jan¹  Smeets, Joep L. R. M.¹  Keuper, Wessel¹  Brouwer, Marc A.¹ 

[1] Radboud Univ Nijmegen, Med Ctr, Dept Cardiol, Geert Grootepl Zuid 10, NL-6525 GA Nijmegen, Netherlands

[2] Slingeland Hosp, Dept Cardiol, Kruisbergseweg 25, NL-7009 BL Doetinchem, Netherlands

[3] Univ Twente, Dept Appl Math, Fac Elect Engn Math & Comp Sci, POB 217, NL-7500 AE Enschede, Netherlands

关键词: Ventricular fibrillation;    Fourier analysis;    Electrocardiography;    Left ventricular mass;    Left ventricular diameter;    Implantable cardioverter defibrillator;   

DOI  :  10.1016/j.resuscitation.2017.03.029

来源: Elsevier

【 摘 要 】

Background: Despite a promising association between VF waveform characteristics and prognosis after resuscitation, studies with VF-guided treatment have so far not improved outcomes. While driven by the idea that the VF waveform reflects arrest duration, increasing evidence suggests that pre-existent disease-related changes of the myocardium affect ECG-characteristics of VF as well. In this context, we studied the impact of the left ventricular (LV) diameter and mass. Methods: Cohort of 193 ICD-patients with defibrillation testing at the Radboudumc (2010-2014). Surface ECG-recordings (leads I, II, aVF, V1, V3, V6) were analysed to study amplitude and frequency characteristics of the induced VF. Both for LV diameter and mass, patients were categorised in two groups, using echocardiographic data (ASE-guidelines). Results: In all ECG-leads, dominant and median frequencies were significantly lower in patients with (n = 40) than in patients without (n = 151) an increased LV diameter. The mean amplitude and amplitude spectrum area (AMSA) did not differ. In contrast, we observed no differences in frequency characteristics in relation to the LV mass, whereas mean amplitude (I, aVF, V3) and AMSA (I, V3) were significantly higher in patients with (n = 57) than in patients without (n = 120) an increased LV mass. Conclusions: Frequency characteristics of VF were consistently lower in case of an increased LV diameter. Whereas LV mass does not affect the frequency of the VF waveform, amplitudes seem higher with increasing mass. These findings add to the current knowledge of factors that modulate VF characteristics of the surface ECG and provide insight into factors which may be accounted for in future studies on VF-guided resuscitative interventions. (C) 2017 Elsevier B.V. All rights reserved.

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