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Correlations between arrhythmogenic substrate and noninvasive risk stratification in ischemic heart disease patients

Quentin Voglimacci-Stephanopoli¹, Anne Rollin¹, Pierre Mondoly¹

¹Department of Cardiology, University Hospital Rangueil, Toulouse, France.

Journal of Cardiovascular Electrophysiology

|August 22, 2019

Abstract

Introduction:

Several noninvasive risk factors for ventricular arrhythmias have been described in postmyocardial infarction (MI) patients, whose relationships with scar characteristics and modifications by ablation are unknown.

Methods:

Twenty-two patients with previous MI referred for ventricular tachycardia ablation were prospectively included. ECG, heart rate variability (HRV), signal-averaged ECG (SA-ECG), and T wave alternans (TWA) were performed before and after radiofrequency ablation. Scar areas were correlated to preablation parameters. Pre and postablation parameters were furthermore compared.

Results:

Left ventricular ejection fraction and some spectral and time-domain HRV parameters were significantly correlated to the scar areas. QRS duration was larger after vs before ablation (120 ± 29 vs 105 ± 22 msec, P = .01). No significant modification in time or spectral domain of HRV was observed. There was no significant change in TWA and SA-ECG before and after ablation. Borderline decreases in quantitative TWA parameters were noted in patients with positive TWA and successful ablation procedure.

Conclusion:

Some noninvasive risk factors were linked to the scar areas, but few were significantly modified after ablation. Larger populations are needed to demonstrate significant differences or correlations.

Keywords:

T wave alternans ablation heart rate variability scar signal-averaged ECG ventricular tachycardia

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