Electrocardiographic characteristics of patients with false tendon: Possible association of false tendon with J waves

Nakagawa, Mikiko; Ezaki, Kaori; Miyazaki, Hiroko; Wakisaka, Osamu; Shinohara, Tetsuji; Teshima, Yasushi; Yufu, Kunio; Takahashi, Naohiko; Saikawa, Tetsunori

doi:10.1016/j.hrthm.2011.12.022

Cited by 25 publications

(19 citation statements)

References 30 publications

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“…The electrophysiology of FT and their potential involvement in ILVT has been investigated in several earlier reports. There appears to be some correlation between FTs and nonspecific repolarization abnormalities on the sinus rhythm electrocardiogram . Histologically, FTs have been found to contain Purkinje fibers, as shown by Canale et al.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of left ventricular false tendons in children with idiopathic left ventricular tachycardia

Merlocco

Brown

Mah

et al. 2018

Pacing Clinical Electrophis

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Section: Discussionmentioning

confidence: 99%

Evaluation of left ventricular false tendons in children with idiopathic left ventricular tachycardia

Merlocco

Brown

Mah

et al. 2018

Pacing Clinical Electrophis

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“…Autopsy studies of normal human hearts reported a 55%–68% prevalence rate of prominent left ventricular trabeculations and false tendons 33 . Recently Nakagawa et al 34 reported high incidence of J-waves on ECG in subjects with false tendon, detected by echocardiography. We speculate that such peculiar structural features without abnormally high I to could be responsible for benign J-point elevation on 12 leads ECG.…”

Section: Discussionmentioning

confidence: 99%

Intracardiac J-point elevation before the onset of polymorphic ventricular tachycardia and ventricular fibrillation in patients with an implantable cardioverter-defibrillator

et al. 2012

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Background The clinical importance of the J-point elevation on ECG is controversial. Objective Study intracardiac J-point amplitude before ventricular arrhythmia. Methods Baseline 12-lead ECGs and far-field (FF) right ventricular (RV) intracardiac ICD electrograms (EGMs) were recorded at rest in 494 patients [mean age 60.4±13.1; 360 (72.9%) men] with structural heart disease [278 (56.3%) ischemic cardiomyopathy] who received primary [463 (93.9%) patients] or secondary prevention ICD. Ten-second intracardiac FF EGMs before the onset of arrhythmia were compared with the baseline. The J-point amplitude was measured on the baseline 12-lead surface ECG and the intracardiac FF EGM. The relative J-point amplitude was calculated as the ratio of J-point amplitude to peak-to-peak R-wave. Results The paired t-test showed that the relative intracardiac J-point amplitude was significantly higher before polymorphic ventricular tachycardia (PVT)/ventricular fibrillation (VF) onset (0.28±0.08 vs. −0.19±0.39; p=0.012) than at baseline. In a mixed-effects logistic regression model, adjusted for multiple episodes per patient, each 10% increase in relative J-point amplitude increased the odds of having VT/VF by 13% [OR 1.13 (95% CI 1.07–1.19); P<0.0001] and increased the odds of having PVT/VF by 27% [OR 1.27 (95% CI 1.11–1.46); P=0.001]. Conclusion The relative intracardiac J-point amplitude is augmented immediately before the onset of PVT/VF in patients with structural heart disease.

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“…discrete, fibromuscular structures that transverse the LV cavity, are related to the genesis of J waves has also been raised. 10 However, there has been evidence suggesting that the early repolarisation pattern may be associated with a risk for VF, depending on the location of early repolarisation, magnitude of the J wave and degree of ST elevation. 2,11,12 In a large study on a communitybased general population of 10,864 middle-aged subjects, an early repolarisation pattern with J-point elevation of at least 0.1 mV in the inferior leads of a resting ECG was associated with an increased risk of death from cardiac causes.…”

Section: Clinical Significancementioning

confidence: 99%

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confidence: 99%

Early Repolarisation Syndrome – New Concepts

Katritsis

Gersh

2015

Arrhythmia &Amp; Electrophysiology Review

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Early repolarisation pattern is defined electrocardiographically by a distinct J wave or J-point elevation that is either a notch or a slur of the terminal part of the QRS entirely above the baseline, with or without ST-segment elevation. The peak of the notch or slur (J p ) should be ≥0.1 mV in two or more contiguous leads, excluding leads V1 to V2 (see Figure 1).1,2 Early repolarisation syndromes (ERS) refer to sudden cardiac death or documented VT/VF in individuals with an early repolarisation pattern.A prominent J wave has been long observed in cases of hypothermia hypercalcaemia and ischaemia.3 The term J-wave syndromes usually denotes inherited conditions such as ERS and the Brugada syndrome, 4 which are due to mutations affecting calcium, potassium and sodium channels and may contribute to overlap syndromes. 4,5 Genetics and PathophysiologyThe J-wave deflection occurring at the QRS-ST junction (also known as the Osborn wave) was first described in 1953 and is seen in many conditions such as acute ischaemia (especially in true posterior myocardial infarction), hypothermia, hypercalcaemia, brain injury, acidosis and early repolarisation syndromes. An increase in net repolarising current, due to either a decrease of inward Na + or Ca 2+ currents (I Na, and I Ca,L ), or augmentation of outward currents, such as Ito, I K-ATP, and I K-ACh, lead to augmentation of the J wave or the appearance of ST-segment elevation that is more prominent during slow heart rates.Overlap with other syndromes may be seen. Mutations in the SCN10A gene may produce patterns of Brugada, early repolarisation and conduction disease, 5 and a high prevalence of early repolarisation in short QT syndrome has also been reported. 6 Physiological heterogeneity of electrical properties and transmural gradients in ion channel distribution in the endocardial, midmyocardial (M cells) and epicardial layers result in regional differences in electrophysiological properties. Clinical SignificanceThe early repolarisation pattern has long been considered to be a benign ECG manifestation (6-13 % in the general population), that is seen more commonly in young healthy men and athletes (22-44 %) and its clinical significance has been questioned. 7 In a recent report on professional athletes, a correlation between J-point elevation and interventricular septum thickness was observed, suggesting a possible mechanistic role of exercise-induced left ventricular hypertrophy as the basis for J-point elevation, and no cardiac death was observed in a median of 13 years follow-up. 8 Similarly, in the CARDIA study, the presence of early repolarisation in young adults was not associated with higher risk of death during long-term follow-up. 9 The possibility that false tendons, e.g. discrete, fibromuscular structures that transverse the LV cavity, are related to the genesis of J waves has also been raised. 10 However, there has been evidence suggesting that the early repolarisation pattern may be associated with a risk for VF, depending on the location of early repol...

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Electrocardiographic characteristics of patients with false tendon: Possible association of false tendon with J waves

Cited by 25 publications

References 30 publications

Evaluation of left ventricular false tendons in children with idiopathic left ventricular tachycardia

Evaluation of left ventricular false tendons in children with idiopathic left ventricular tachycardia

Intracardiac J-point elevation before the onset of polymorphic ventricular tachycardia and ventricular fibrillation in patients with an implantable cardioverter-defibrillator

Early Repolarisation Syndrome – New Concepts

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