Ventricular fibrillation waveform characteristics differ according to the presence of a previous myocardial infarction: A surface ECG study in ICD-patients

RESUSCITATION

卷:96

Article

Bonnes, Judith L.¹  Thannhauser, Jos¹  Hermans, Mathilde C.¹  Westra, Sjoerd W.¹  Oostendorp, Thom F.²  Meinsma, Gjerrit³  de Boer, Menko Jan¹  Brouwer, Marc A.¹  Smeets, Joep L. R. M.¹ 

[1] Radboud Univ Nijmegen, Med Ctr, Dept Cardiol, NL-6500 HB Nijmegen, Netherlands

[2] Radboud Univ Nijmegen, Med Ctr, Donders Ctr Neurosci, Dept Cognit Neurosci, NL-6500 HB Nijmegen, Netherlands

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

关键词: Ventricular fibrillation;    Fourier analysis;    Myocardial infarction;    Implantable cardioverter defibrillator;    Electrocardiography;   

DOI  :  10.1016/j.resuscitation.2015.08.014

来源: Elsevier

【 摘 要 】

Background: Characteristics of the ventricular fibrillation (VF) waveform reflect arrest duration and have been incorporated in studies on algorithms to guide resuscitative interventions. Findings in animals indicate that VF characteristics are also affected by the presence of a previous myocardial infarction (MI). As studies in humans are scarce, we assessed the impact of a previous MI on VF characteristics in ICD-patients. Methods: Prospective cohort of ICD-patients (n = 190) with defibrillation testing at the Radboudumc (2010-2013). VF characteristics of the 12-lead surface ECG were compared between three groups: patients without a history of MI (n = 88), with a previous anterior (n = 47) and a previous inferior MI (n = 55). Results: As compared to each of the other groups, the mean amplitude and amplitude spectrum area were lower, for an anterior MI in lead V3 and for an inferior MI in leads II and aVF. Across the three groups, the bandwidth was broader in the leads corresponding with the infarct localisation. In contrast, the dominant and median frequencies only differed between previous anterior MI and no history of MI, being lower in the former. Conclusions: The VF waveform is affected by the presence of a previous MI. Amplitude-related measures were lower and VF was less organised in the ECG-lead(s) adjacent to the area of infarction. Although VF characteristics of the surface ECG have so far primarily been considered a proxy for arrest duration and metabolic state, our findings question this paradigm and may provide additional insights into the future potential of VF-guided resuscitative interventions. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

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