Arrhythmias & electrophysiology
Distinct Substrates of Idiopathic Ventricular Fibrillation Revealed by Arrhythmia Characteristics on Implantable Cardioverter-Defibrillator
Authors' conclusion
Characteristics of arrhythmia recurrences on implantable cardioverter- defibrillator provide phenotypic markers of the distinct and hidden substrates underlying IVF.
Study context
- Population
- Patients with initial diagnosis of idiopathic ventricular fibrillation (IVF) and recurrent arrhythmia at follow-up without antiarrhythmic drugs, with mapping demonstrating Purkinje (Purk) or MiCM substrate117 arrhythmia recurrences
- Participants
- 95 patients
- Exposure
- MiCM vs Purk substrate of IVF
- MiCMn = 41
- Purkn = 54
- Outcome
- Arrhythmia characteristics on ICD discriminating substrate
Methodological details32 centres
- 32 centres
Main finding
As reported in the abstract
Sinus tachycardia (≤570 ms)
P = 0.014
Short-coupled (<350 ms) triggers
| Outcome | MiCM | Purk | P value |
|---|---|---|---|
| VFCL | 215 ± 24 ms | 182 ± 15 ms | P < 0.001 |
- Purk vs MiCM: P = 0.001 — short-coupled triggers
- Multivariable combination accuracy (range 0.833-1.000)
- 0.93 ± 0.05
- IVF substrates discriminated with high probability (>80%)
- 81%
Observational data: associations, not effects.
Original publication
Distinct Substrates of Idiopathic Ventricular Fibrillation Revealed by Arrhythmia Characteristics on Implantable Cardioverter-Defibrillator. JACC Clin Electrophysiol. Published 3 July 2024. doi:10.
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