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[Data of programmed ventricular stimulation in left ventricular hypertrophy of hypertensive origin]
J Clémenty1, P Coste, M Dallocchio
1Service de Cardiologie, Hôpital du Haut-Lévèque, Passac.
Insights
Hypertension patients with left ventricular hypertrophy (LVH) face increased sudden death risk. Programmed ventricular stimulation (PVS) reveals LVH increases ventricular vulnerability, while Holter recording (HR) identifies triggers, not the substrate.
Area of Science:
- Cardiology
- Electrophysiology
- Hypertension Research
Context:
- Hypertension is a significant risk factor for cardiovascular events, including sudden cardiac death.
- Left ventricular hypertrophy (LVH) is a common complication of hypertension and is associated with increased mortality.
- The electrophysiological mechanisms underlying sudden death in hypertensive patients with LVH require further elucidation.
Purpose:
- To investigate the electrophysiological factors contributing to sudden death in hypertensive patients with and without left ventricular hypertrophy (LVH).
- To assess the utility of Holter recording (HR) and programmed ventricular stimulation (PVS) in evaluating ventricular vulnerability in this patient cohort.
Summary:
- This study utilized Holter recording (HR) and programmed ventricular stimulation (PVS) in 24 hypertensive patients (12 with LVH, 12 without) to explore electrophysiological substrates of sudden death.
- Results indicate that LVH significantly increases ventricular vulnerability, which is effectively assessed by PVS.
- HR and PVS were found to be uncorrelated, suggesting HR identifies triggering factors rather than the arrhythmogenic substrate of LVH.
- A correlation was observed between the degree of LV anatomical hypertrophy and the AH interval duration.
Impact:
- Findings highlight PVS as a crucial tool for assessing arrhythmogenic substrate in hypertensive patients with LVH.
- Differentiates the roles of HR and PVS in risk stratification for sudden cardiac death.
- Provides insights into the relationship between anatomical LVH and electrophysiological parameters, informing clinical management strategies.
Abstract:
Various studies have established the increase of sudden death in hypertensive patients with left ventricular hypertrophy (LVH). In order to specify its most important factors, an electrophysiological study consisting of Holter recording (HR) and programmed ventricular stimulation (PVS), was performed in 24 patients with hypertension: 12 with LVH and 12 without LVH, on ultrasonography. In all patients, coronary angiography was normal. The results are the following: 1) LVH increases the ventricular vulnerability, this arrhythmogenic substrate and its stability are explored by PVS; 2) HR and PVS are not correlated, therefore HR does not explore the arrhythmogenic substrate of LVH, but rather the potential triggering factors of severe rhythm disorders; 3) it has not been possible to evaluate the role of the autonomous nervous system in this study; 4) finally, a significant correlation was found between the degree of anatomical hypertrophy of the LV and the duration of the interval AH.