Arrhythmias & electrophysiology
Triggers of Ventricular Fibrillation in Patients With Inferolateral J-Wave Syndrome
Authors' conclusion
VF initiation in inferolateral J-wave syndrome is associated with significant individual heterogeneity in trigger characteristics. Myocardial triggers have electrocardiographic features distinct from Purkinje triggers, and their origin often colocalizes with an abnormal epicardial substrate.
Study context
- Population
- Patients with spontaneous ventricular fibrillation (VF) episodes associated with inferolateral J waves37 VF triggers
- Participants
- 31 patients
- Outcome
- Origin and characteristics of VF triggers
Main finding
As reported in the abstract
VF trigger characteristics
- QRS duration of triggers (mean ± SD; range 119-219 ms)
- 176 ± 21 milliseconds
- Coupling interval of triggers (mean ± SD; range 250-508 ms)
- 339 ± 46 milliseconds
- Right bundle branch block (BBB) trigger pattern
- 70%
- Left BBB trigger pattern
- 30%
- Triggers from Purkinje system (EP study: 22 triggers, 19 patients)
- 6
- Triggers from ventricular myocardium
- 10
- Triggers of undetermined origin
- 6
- Abnormal epicardial substrate with fragmented electrograms (patients)
- 9
- Triggers originating from the same region as abnormal substrate (patients)
- 7
Observational data: associations, not effects.
Further findings
VF suppression after catheter ablation
- Patients with VF suppression
- 15 (79%)
Original publication
Triggers of Ventricular Fibrillation in Patients With Inferolateral J-Wave Syndrome. JACC Clin Electrophysiol. Published 18 October 2023. doi:10.
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