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 Pak

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)33-39
Number of pages7
JournalProgress in Biophysics and Molecular Biology
Volume116
Issue number1
DOIs
Publication statusPublished - 2014 Sep 1

Bibliographical note

Funding Information:
This research was financially supported by the Ministry of Trade, Industry & Energy (MOTIE), Korea Institute for Advancement of Technology (KIAT) and Gangwon Institute for Regional Program Evaluation (GWIRPE) through the Leading Industry Development for Economic Region ( A002200868 ), a grant ( A085136 ) from the Korea Health 21 R&D Project , Ministry of Health and Welfare, and a grant ( 2012027176 ) from the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (MSIP) .

Publisher Copyright:
© 2014 Elsevier Ltd.

All Science Journal Classification (ASJC) codes

  • Biophysics
  • Molecular Biology

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