From the Department of Cardiology, Keio University School of Medicine, Tokyo, Japan (Y.A., S.T., T.N., T.K., S.K., K.F.); Department of Cardiovascular Medicine Gunma University Graduate School of Medicine, Japan (Y.K.); Department of Cardiology, Nagoya University Graduate School of Medicine, Japan (Y.I.); Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Japan (N.T.); Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan (S.N.); and Division of Research and Development, Tachikawa Medical Center, Niigata, Japan (Y.A.).
Circ Arrhythm Electrophysiol. 2017 Jul;10(7). doi: 10.1161/CIRCEP.117.005214.
To know the underlying mechanisms of J waves, the response to atrial pacing was studied in patients with idiopathic ventricular fibrillation (IVF) and patients with non-IVF.
In 8 patients with IVF, the J-wave amplitude was measured before, during, and after atrial pacing. All patients had episodes of ventricular fibrillation without structural heart disease. The responses of J waves were compared with those of the 17 non-IVF control subjects who revealed J waves but no history of cardiac arrest and underwent electrophysiological study. The IVF patients were younger than the non-IVF patients (28±10 versus 52±14 years, respectively; =0.002) and had larger J waves with more extensive distribution. J waves decreased from 0.35±0.26 to 0.22±0.23 mV (=0.025) when the RR intervals were shortened from 782±88 to 573±162 ms (=0.001). A decrease (≥0.05 mV) in the J-wave amplitude was observed in 6 of the 8 patients. In addition, 1 patient showed a distinct reduction of J waves in the unipolar epicardial leads. In contrast, J waves were augmented in the 17 non-IVF subjects from 0.27±0.09 to 0.38±0.10 mV (<0.001): augmented in 9 and unchanged in the 8 subjects. The different response patterns of J waves to rapid pacing suggest different mechanisms: early repolarization in IVF patients and conduction delay in non-IVF patients.
The response to atrial pacing was different between the IVF and non-IVF patients, which suggests the presence of different mechanisms for the genesis of J waves.
为了了解 J 波的潜在机制，研究了特发性心室颤动（IVF）患者和非-IVF 患者对心房起搏的反应。
在 8 例 IVF 患者中，测量了心房起搏前、起搏中和起搏后的 J 波幅度。所有患者均无结构性心脏病，但均有室颤发作。比较了 J 波的反应与 17 例非-IVF 对照患者的反应，这些患者有 J 波但无心脏骤停史，并进行了电生理研究。IVF 患者比非-IVF 患者年轻（分别为 28±10 岁和 52±14 岁，=0.002），J 波更大，分布更广。当 RR 间期从 782±88ms 缩短至 573±162ms 时，J 波从 0.35±0.26mV 降至 0.22±0.23mV（=0.025）。8 例患者中有 6 例 J 波幅度下降（≥0.05mV）。此外，1 例患者在单极心外膜导联中 J 波明显减少。相比之下，在 17 例非-IVF 患者中，J 波从 0.27±0.09mV 增加至 0.38±0.10mV（<0.001）：9 例增加，8 例不变。J 波对快速起搏的不同反应模式表明存在不同的机制：IVF 患者为早期复极，非-IVF 患者为传导延迟。
IVF 和非-IVF 患者对心房起搏的反应不同，这表明 J 波产生的机制不同。
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