Hwang, Minki, Lee, Hancheol, Lee, Young-Seon, Chung, Soonwon, Choi, Sung Hwan, Shim, Eun Bo, and Pak, Hui-Nam
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 (FibN VT/ VF 1) or LV end-diastolic dimension (FibN VT/VF 2). We compared the maintenance duration of VT/VF for various FibN values using computational modeling, and tested FibN VT/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. FibN VT/VF s were significantly higher in patients with ICD than in control (both FibN VT/VF 1 and FibN VT/VF 2, p < 0.001). 3. Within ICD group, FibN VT/VF values were higher in patients with cardiomyopathy than those without (both FibN VT/VF 1 and FibN VT/VF 2, p < 0.001). 4. During 50 ± 39 months follow-up period, the frequency of appropriate ICD therapy was higher in the high FibN VT/VF group (FibN VT/VF 1, p = 0.001; FibN VT/VF 2, p = 0.002). Both FibN VT/VF 1 (HR 2.51, 95%CI 1.48–4.24, p = 0.001) and FibN VT/VF 2 (HR 2.11, 95%CI 1.25–3.55, p = 0.005) were independently associated with appropriate ICD therapy in multi-variate analyses. Conclusion FibN VT/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. [ABSTRACT FROM AUTHOR]