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

 Minki Hwang  ;  Hancheol Lee  ;  Young-Seon Lee  ;  Soonwon Chung  ;  Sung Hwan Choi  ;  Eun Bo Shim  ;  Hui-Nam Paka, 
 Progress in Biophysics and Molecular Biology, Vol.116(1) : 33-39, 2014 
Journal Title
 Progress in Biophysics and Molecular Biology 
Issue Date
Computer Simulation ; Defibrillators, Implantable* ; Diagnosis, Computer-Assisted/methods ; Female ; Heart Conduction System/physiopathology* ; Heart Ventricles/physiopathology* ; Humans ; Male ; Middle Aged ; Models, Cardiovascular* ; Patient-Specific Modeling ; Reproducibility of Results ; Sensitivity and Specificity ; Therapy, Computer-Assisted/methods ; Ventricular Fibrillation/diagnosis ; Ventricular Fibrillation/physiopathology* ; Ventricular Fibrillation/prevention & control*
Arrhythmogenecity ; Computational modeling ; Implantable cardioverter defibrillator ; Ventricular fibrillation ; Ventricular tachycardia
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.
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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
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Lee, Young Seon(이영선)
Lee, Han Cheol(이한철)
Hwang, Min Ki(황민기)
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