The relationship between J wave and ventricular tachycardia during Takotsubo cardiomyopathy

초록

Takotsubo cardiomyopathy (TTC) occasionally causes lifethreatening ventricular arrhythmia. It has been also reported that J wave on the surface electrocardiography (sECG) has been associated with idiopathic ventricular fibrillation and cardiac events. We investigated whether the presence of J wave on sECG could be a potential risk factor for ventricular arrhythmia during TTC. We performed a retrospective study of 80 patients who were diagnosed with TTC in Inha University Hospital (age=67±15 years, 38 male). Among the patients, 20 (25%) patients were classified as a Ventricular tachycardia (VT) group (age=69±14 years, 13 male) and 60 (75%) as a NonVT group (age=66±16 years, 25 male). The J wave on the sECG was defined as a J point elevation manifested through QRS notching or slurring of at least 1mm above the baseline in at least two leads. The prevalence of J wave is significantly higher in VT group than NonVT group during TTC (15 (75 %) vs. 15 (25%), p=0.001). The patients with J wave had higher prevalence of ventricular tachycardia than the patients without J wave (15 (50%) vs. 5 (10%), p<0.001). Corrected QT interval (QTc) was significantly longer in VT group during TCC than nonVT group (577.00±58.52 ms vs. 534.19±61.98 ms, p=0.009). In a multivariate analysis, the presence of J wave, QTc duration, male gender came out to be independent predictors of VT during TTC (odds ratio 9.338&#894; p = 0.001, odds ratio 1.010&#894; p = 0.045, odds ratio 4.126&#894; p = 0.036, respectively). This study suggests that the presence of J wave on the sECG is significantly related to ventricular arrhythmia during Takotsubo cardiomyopathy. These finding may indicate that the presence of J wave is independent potent predictors of VT during Takotsubo cardiomyopathy.