Distinct spectral dynamics of implanted cardiac defibrillator signals in spontaneous termination of polymorphic ventricular tachycardia and fibrillation in patients with electrical and structural diseases.

AIMS To determine the spectral dynamics of early spontaneous polymorphic ventricular tachycardia and ventricular fibrillation (PVT/VF) in humans. METHODS AND RESULTS Fifty-eight self-terminated and 173 shock-terminated episodes of spontaneously initiated PVT/VF recorded by Medtronic implanted cardia...

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Autores: Calvo, David, Salinas, Lucia, Martínez-Camblor, Pablo, García-Iglesias, Daniel, Alzueta, Javier, Rodríguez, Anibal, Romero, Rafael, Viñolas, Xavier, Fernández-Lozano, Ignacio, Anguera, Ignasi, Villacastín, Julián, Bodegas, Andrés, Fontenla, Adolfo, Jalife, Jose, Berenfeld, Omer
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/16697
Acceso en línea:http://hdl.handle.net/20.500.12105/16697
Access Level:acceso abierto
Palabra clave:Defibrillators, Implantable
Tachycardia, Ventricular
Humans
Arrhythmias, Cardiac
Ventricular Fibrillation
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spelling Distinct spectral dynamics of implanted cardiac defibrillator signals in spontaneous termination of polymorphic ventricular tachycardia and fibrillation in patients with electrical and structural diseases.Calvo, DavidSalinas, LuciaMartínez-Camblor, PabloGarcía-Iglesias, DanielAlzueta, JavierRodríguez, AnibalRomero, RafaelViñolas, XavierFernández-Lozano, IgnacioAnguera, IgnasiVillacastín, JuliánBodegas, AndrésFontenla, AdolfoJalife, JoseBerenfeld, OmerDefibrillators, ImplantableTachycardia, VentricularHumansArrhythmias, CardiacVentricular FibrillationAIMS To determine the spectral dynamics of early spontaneous polymorphic ventricular tachycardia and ventricular fibrillation (PVT/VF) in humans. METHODS AND RESULTS Fifty-eight self-terminated and 173 shock-terminated episodes of spontaneously initiated PVT/VF recorded by Medtronic implanted cardiac defibrillators (ICDs) in 87 patients with various cardiac pathologies were analyzed by short fast Fourier transform of shifting segments to determine the dynamics of dominant frequency (DF) and regularity index (RI). The progression in the intensity of DF and RI accumulations further quantified the time course of spectral characteristics of the episodes. Episodes of self-terminated PVT/VF lasted 8.6 s [95% confidence interval (CI): 8.1-9.1] and shock-terminated lasted 13.9 s (13.6-14.3) (P < 0.001). Recordings from patients with primarily electrical pathologies displayed higher DF and RI values than those from patients with primarily structural pathologies (P < 0.05) independently of ventricular function or antiarrhythmic drug therapy. Regardless of the underlying pathology, the average DF and RI intensities were lower in self-terminated than shock-terminated episodes [DF: 3.67 (4.04-4.58) vs. 4.32 (3.46-3.93) Hz, P < 0.001; RI: 0.53 (0.48-0.56) vs. 0.63 (0.60-0.65), P < 0.001]. In a multivariate analysis controlled by the type of pathology and clinical variables, regularity remained an independent predictor of self-termination [hazard ratio: 0.954 (0.928-0.980)]. Receiver operating characteristic (ROC) curve analysis of DF and RI intensities demonstrated increased predictability for self-termination in time with 95% CI above the 0.5 cut-off limit at about t = 8.6 s and t = 6.95 s, respectively. CONCLUSION Consistent with the notion that fast organized sources maintain PVT/VF in humans, reduction of frequency and regularity correlates with early self-termination. Our findings might help generate ICD methods aiming to reduce inappropriate shock deliveries.Oxford University PressInstituto de Salud Carlos IIISociedad Española de CardiologíaNational Institutes of Health (Estados Unidos)20232023-11-1720222022-11-2220222022-11-22journal articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/20.500.12105/16697reponame:Repisaludinstname:Instituto de Salud Carlos III (ISCIII)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Atribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repisalud.isciii.es:20.500.12105/166972026-06-12T12:43:37Z
dc.title.none.fl_str_mv Distinct spectral dynamics of implanted cardiac defibrillator signals in spontaneous termination of polymorphic ventricular tachycardia and fibrillation in patients with electrical and structural diseases.
title Distinct spectral dynamics of implanted cardiac defibrillator signals in spontaneous termination of polymorphic ventricular tachycardia and fibrillation in patients with electrical and structural diseases.
spellingShingle Distinct spectral dynamics of implanted cardiac defibrillator signals in spontaneous termination of polymorphic ventricular tachycardia and fibrillation in patients with electrical and structural diseases.
Calvo, David
Defibrillators, Implantable
Tachycardia, Ventricular
Humans
Arrhythmias, Cardiac
Ventricular Fibrillation
title_short Distinct spectral dynamics of implanted cardiac defibrillator signals in spontaneous termination of polymorphic ventricular tachycardia and fibrillation in patients with electrical and structural diseases.
title_full Distinct spectral dynamics of implanted cardiac defibrillator signals in spontaneous termination of polymorphic ventricular tachycardia and fibrillation in patients with electrical and structural diseases.
title_fullStr Distinct spectral dynamics of implanted cardiac defibrillator signals in spontaneous termination of polymorphic ventricular tachycardia and fibrillation in patients with electrical and structural diseases.
title_full_unstemmed Distinct spectral dynamics of implanted cardiac defibrillator signals in spontaneous termination of polymorphic ventricular tachycardia and fibrillation in patients with electrical and structural diseases.
title_sort Distinct spectral dynamics of implanted cardiac defibrillator signals in spontaneous termination of polymorphic ventricular tachycardia and fibrillation in patients with electrical and structural diseases.
dc.creator.none.fl_str_mv Calvo, David
Salinas, Lucia
Martínez-Camblor, Pablo
García-Iglesias, Daniel
Alzueta, Javier
Rodríguez, Anibal
Romero, Rafael
Viñolas, Xavier
Fernández-Lozano, Ignacio
Anguera, Ignasi
Villacastín, Julián
Bodegas, Andrés
Fontenla, Adolfo
Jalife, Jose
Berenfeld, Omer
author Calvo, David
author_facet Calvo, David
Salinas, Lucia
Martínez-Camblor, Pablo
García-Iglesias, Daniel
Alzueta, Javier
Rodríguez, Anibal
Romero, Rafael
Viñolas, Xavier
Fernández-Lozano, Ignacio
Anguera, Ignasi
Villacastín, Julián
Bodegas, Andrés
Fontenla, Adolfo
Jalife, Jose
Berenfeld, Omer
author_role author
author2 Salinas, Lucia
Martínez-Camblor, Pablo
García-Iglesias, Daniel
Alzueta, Javier
Rodríguez, Anibal
Romero, Rafael
Viñolas, Xavier
Fernández-Lozano, Ignacio
Anguera, Ignasi
Villacastín, Julián
Bodegas, Andrés
Fontenla, Adolfo
Jalife, Jose
Berenfeld, Omer
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Instituto de Salud Carlos III
Sociedad Española de Cardiología
National Institutes of Health (Estados Unidos)
dc.subject.none.fl_str_mv Defibrillators, Implantable
Tachycardia, Ventricular
Humans
Arrhythmias, Cardiac
Ventricular Fibrillation
topic Defibrillators, Implantable
Tachycardia, Ventricular
Humans
Arrhythmias, Cardiac
Ventricular Fibrillation
description AIMS To determine the spectral dynamics of early spontaneous polymorphic ventricular tachycardia and ventricular fibrillation (PVT/VF) in humans. METHODS AND RESULTS Fifty-eight self-terminated and 173 shock-terminated episodes of spontaneously initiated PVT/VF recorded by Medtronic implanted cardiac defibrillators (ICDs) in 87 patients with various cardiac pathologies were analyzed by short fast Fourier transform of shifting segments to determine the dynamics of dominant frequency (DF) and regularity index (RI). The progression in the intensity of DF and RI accumulations further quantified the time course of spectral characteristics of the episodes. Episodes of self-terminated PVT/VF lasted 8.6 s [95% confidence interval (CI): 8.1-9.1] and shock-terminated lasted 13.9 s (13.6-14.3) (P < 0.001). Recordings from patients with primarily electrical pathologies displayed higher DF and RI values than those from patients with primarily structural pathologies (P < 0.05) independently of ventricular function or antiarrhythmic drug therapy. Regardless of the underlying pathology, the average DF and RI intensities were lower in self-terminated than shock-terminated episodes [DF: 3.67 (4.04-4.58) vs. 4.32 (3.46-3.93) Hz, P < 0.001; RI: 0.53 (0.48-0.56) vs. 0.63 (0.60-0.65), P < 0.001]. In a multivariate analysis controlled by the type of pathology and clinical variables, regularity remained an independent predictor of self-termination [hazard ratio: 0.954 (0.928-0.980)]. Receiver operating characteristic (ROC) curve analysis of DF and RI intensities demonstrated increased predictability for self-termination in time with 95% CI above the 0.5 cut-off limit at about t = 8.6 s and t = 6.95 s, respectively. CONCLUSION Consistent with the notion that fast organized sources maintain PVT/VF in humans, reduction of frequency and regularity correlates with early self-termination. Our findings might help generate ICD methods aiming to reduce inappropriate shock deliveries.
publishDate 2022
dc.date.none.fl_str_mv 2022
2022-11-22
2022
2022-11-22
2023
2023-11-17
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/20.500.12105/16697
url http://hdl.handle.net/20.500.12105/16697
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Atribución 4.0 Internacional
http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Atribución 4.0 Internacional
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Oxford University Press
publisher.none.fl_str_mv Oxford University Press
dc.source.none.fl_str_mv reponame:Repisalud
instname:Instituto de Salud Carlos III (ISCIII)
instname_str Instituto de Salud Carlos III (ISCIII)
reponame_str Repisalud
collection Repisalud
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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