| Title: |
Non-invasive detection of exercise-induced cardiac conduction abnormalities in sudden cardiac death survivors in the inherited cardiac conditions |
| Authors: |
Leong, KMW; Ng, FS; Shun-Shin, MJ; Koa-Wing, M; Qureshi, N; Whinnett, ZI; Linton, NF; Lefroy, D; Francis, DP; Harding, SE; Davies, DW; Peter, NS; Lim, PB; Behr, E; Lambiase, PD; Varnava, A; Kanagaratnam, P |
| Source: |
Europace , 23 (2) pp. 305-312. (2021) |
| Publication Year: |
2021 |
| Collection: |
University College London: UCL Discovery |
| Subject Terms: |
Brugada syndrome; Hypertrophic cardiomyopathy; Idiopathic ventricular fibrillation; Risk stratification; Sudden cardiac death; Ventricular conduction stability |
| Description: |
AIMS : Rate adaptation of the action potential ensures spatial heterogeneities in conduction across the myocardium are minimized at different heart rates providing a protective mechanism against ventricular fibrillation (VF) and sudden cardiac death (SCD), which can be quantified by the ventricular conduction stability (V-CoS) test previously described. We tested the hypothesis that patients with a history of aborted SCD due to an underlying channelopathy or cardiomyopathy have a reduced capacity to maintain uniform activation following exercise. METHODS AND RESULTS : Sixty individuals, with (n = 28) and without (n = 32) previous aborted-SCD event underwent electro-cardiographic imaging recordings following exercise treadmill test. These included 25 Brugada syndrome, 13 hypertrophic cardiomyopathy, 12 idiopathic VF, and 10 healthy controls. Data were inputted into the V-CoS programme to calculate a V-CoS score that indicate the percentage of ventricle that showed no significant change in ventricular activation, with a lower score indicating the development of greater conduction heterogeneity. The SCD group, compared to those without, had a lower median (interquartile range) V-CoS score at peak exertion [92.8% (89.8-96.3%) vs. 97.3% (94.9-99.1%); P < 0.01] and 2 min into recovery [95.2% (91.1-97.2%) vs. 98.9% (96.9-99.5%); P < 0.01]. No significant difference was observable later into recovery at 5 or 10 min. Using the lowest median V-CoS scores obtained during the entire recovery period post-exertion, SCD survivors had a significantly lower score than those without for each of the different underlying aetiologies. CONCLUSION : Data from this pilot study demonstrate the potential use of this technique in risk stratification for the inherited cardiac conditions. |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| Relation: |
https://discovery.ucl.ac.uk/id/eprint/10128026/ |
| Availability: |
https://discovery.ucl.ac.uk/id/eprint/10128026/3/Lambiase_Non-invasive%20detection%20of%20exercise-induced%20cardiac%20conduction%20abnormalities%20in%20sudden%20cardiac%20death%20survivors%20in%20the%20inherited%20cardiac%20conditions_AAM.pdf; https://discovery.ucl.ac.uk/id/eprint/10128026/ |
| Rights: |
open |
| Accession Number: |
edsbas.F1A0D836 |
| Database: |
BASE |