The relationship between J wave and ventricular tachycardia during Takotsubo cardiomyopathy

초록

The Relationship between J wave and ventricular tachycardia during Takotsubo cardiomyopathy Background & Objectives: Takotsubo cardiomyopathy (TTC) occasionally causes life-threatening 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. There was few data regarding relationship between the J wave and life-threatening ventricular arrhythmia such as ventricular fibrillation (VF) or ventricular tachycardia (VT) in Takotsubo cardiomyopathy (TTC). We sought to investigate whether the presence of J wave could be a potential risk factor for ventricular arrhythmia during TTC. Methods: We performed a retrospective study of 80 patients, (age=66.60±15.24 Years, 38 male) were diagnosed with TTC from 2011 to 2014. Total patients were classified as VT (n=20) and non-VT group (n=60). Clinical and echocardiographic parameters were measured, and surface ECG were analyzed. Provocation factor and subtype of TCC were assessed. Potential effects on ventricular arrhythmia by cardiac risk factor, electrolyte level, peak cardiac level and presence of J wave were analyzed. The J wave on the surface electrocardiography (sECG) was defined as a J point elevation manifested through QRS notching at least 1mm above the baseline in at least two leads. Results: Among the patients, 20 (25%) patients were classified as a VT group. We found that the patients with J wave had higher prevalence of life-threatening ventricular tachycardia (53 vs. 8%, p<0.001) than the patients without J wave. Corrected QT interval was significantly longer in VT group during TCC (534.19±61.98 vs. 577.00±58.52 ms, p=0.009). In a multivariate analysis, the presence of J wave was independent predictor of VT during TTC (odds ratio 8.094, 95% CI 2.20-29.72).