Arrhythmias & electrophysiology
The spatial ventricular gradient is associated with inducibility of ventricular arrhythmias during electrophysiology study
Authors' conclusion
Assessment of electrical heterogeneity by SVG, which reflects abnormal electrophysiologic substrate, adds to LVEF and identifies patients at high and low risk of inducible VA at electrophysiology study.
Study context
- Population
- Adults without prior sustained VA, cardiac arrest or ICD undergoing ventricular stimulation for syncope and nonsustained VT or risk stratification before primary prevention ICD
- Participants
- 143 adults
- Exposure
- Inducible VA vs non-inducible at electrophysiology study
- Induciblen = 34
- Outcome
- Inducible VA during electrophysiology study, by spatial ventricular gradient (SVG) magnitude and direction
Main finding
As reported in the abstract
Inducible VA and its association with LVEF, SVGmag and cosSVGaz
| Group | Value | Median LVEF | SVG magnitude (SVGmag) | Cosine SVG azimuth (cosSVGaz) |
|---|---|---|---|---|
| Inducible | 23.8% | 38% | 29.5 mV·ms | 0.64 |
Inducible
Value23.8%
Median LVEF38%
SVG magnitude (SVGmag)29.5 mV·ms
Cosine SVG azimuth (cosSVGaz)0.64
- Inducible vs Non-inducible: P < 0.0001 — median LVEF 38% vs 50% (lower in inducible)
- Inducible vs Non-inducible: P = 0.0099 — SVGmag 29.5 vs 39.4 mV·ms (smaller in inducible)
- Inducible vs Non-inducible: P = 0.0007 — cosSVGaz 0.64 vs 0.89 (smaller in inducible)
- All low LVEF, SVGmag and cosSVGaz vs all high (dichotomized at medians): 39-fold increase in adjusted odds of inducible VA (65% vs 4% [n = 1] inducible)
- P = 0.002
Observational data: associations, not effects.
Further findings
Inducible VA, all low vs all high LVEF, SVGmag and cosSVGaz (dichotomised at medians)
adjusted odds 39 · P = 0.002
Original publication
The spatial ventricular gradient is associated with inducibility of ventricular arrhythmias during electrophysiology study. Heart Rhythm. Published 6 May 2024. doi:10.
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