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Clinical application of the fibrillation number in patients with an implantable cardioverter defibrillator

Authors
 Minki Hwang  ;  Hancheol Lee  ;  Young-Seon Lee  ;  Soonwon Chung  ;  Sung Hwan Choi  ;  Eun Bo Shim  ;  Hui-Nam Paka, 
Citation
 Progress in Biophysics and Molecular Biology, Vol.116(1) : 33-39, 2014 
Journal Title
 Progress in Biophysics and Molecular Biology 
ISSN
 0079-6107 
Issue Date
2014
Abstract
INTRODUCTION: Although ventricular tachycardia/fibrillation (VT/VF) develops suddenly with catastrophic results, its prediction is limited. We tested the fibrillation number (FibN) for potential predictor of VT/VF using clinical data of implantable cardioverter-defibrillator (ICD) patients after validating the number by computational modeling. METHODS: For clinical application of FibN, we used electrocardiography and echocardiography data: QRS width, QTc, and left ventricular (LV) end-systolic dimension (FibNVT/VF1) or LV end-diastolic dimension (FibNVT/VF2). We compared the maintenance duration of VT/VF for various FibN values using computational modeling, and tested FibNVT/VF in 142 patients with ICD for secondary prevention and 426 patients in age-sex matched control group (81.9% male, 56.1 ± 12.3 years old). RESULTS: 1. Computational results showed a positive correlation between VT/VF maintenance duration and FibN (R = 0.82, p < 0.001). 2. FibNVT/VFs were significantly higher in patients with ICD than in control (both FibNVT/VF1 and FibNVT/VF2, p < 0.001). 3. Within ICD group, FibNVT/VF values were higher in patients with cardiomyopathy than those without (both FibNVT/VF1 and FibNVT/VF2, p < 0.001). 4. During 50 ± 39 months follow-up period, the frequency of appropriate ICD therapy was higher in the high FibNVT/VF group (FibNVT/VF1, p = 0.001; FibNVT/VF2, p = 0.002). Both FibNVT/VF1 (HR 2.51, 95%CI 1.48-4.24, p = 0.001) and FibNVT/VF2 (HR 2.11, 95%CI 1.25-3.55, p = 0.005) were independently associated with appropriate ICD therapy in multi-variate analyses. CONCLUSION: FibNVT/VF, a parameter based on wavelength and heart size, correlates well with maintenance of VT/VF in computational modeling, and may have predictive value for VT/VF events in patients with ICD for secondary prevention.
Full Text
http://www.sciencedirect.com/science/article/pii/S0079610714000935
DOI
10.1016/j.pbiomolbio.2014.09.004
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
5. Research Institutes (연구소) > Yonsei Cardiovascular Research Institute (심혈관연구소) > 1. Journal Papers
5. Research Institutes (연구소) > Yonsei Integrative Research Institute for Cerebral & Cardiovascular Disease (뇌심혈관질환융합연구사업단) > 1. Journal Papers
Yonsei Authors
박희남(Pak, Hui Nam) ORCID logo https://orcid.org/0000-0002-3256-3620
이영선(Lee, Young Seon)
이한철(Lee, Han Cheol)
황민기(Hwang, Min Ki)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138461
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