Abstract 14375: Is J-Wave a Manifestation of Ventricular Repolarization Abnormality?
Purpose: The mechanism of J-wave is not definitely known, although it is generally considered to be a manifestation of ventricular repolarization abnormality. We investigated the current flow consistent with J-wave on electrocardiogram (ECG) using 3-directional magnetocardiography(MCG)with high spacio-temporal resolution.
Methods: Sixty-four-channel 3-D MCG was recorded simultaneously with a digitalized ECG (II, V2, V5) during sinus rhythm in 69 patients (men 54, women 15, mean age 49.2±21.6 ) absence of bundle branch block but with J-wave showing either notched or slurred J-point elevation>0.1mV in at least 2 consecutive leads followed by ST elevation. We compared the direction and distribution of current flow on MCG at the time phase of J-wave with that of the mid to late QRS and ST-T period.
Results Twenty-four patients had organic heart diseases (cardiomyopathy;6, ischemic heart disease;5). 4 of them and 12 of 45 patients without heart disease had episodes of lethal ventricular arrhythmia. J-wave was noticed in the inferior (II,III, and aVF) lead in 67 and in the lateral (V4-V6) lead in 11 patients. The direction and distribution of current flow during the onset of notch to mid slur period was totally different from that of ST-T complex but was accorded with the MCG pattern of mid to late QRS in 66 patients. 28 of 67 patients with inferior J-wave and no patients only with lateral J-wave had the current flow in the inferior direction, although others showed no definite distribution during J-wave period.
Conclusion: MCG analysis strongly suggested that the main component of J-wave is derived from ventricular depolarization.
- © 2012 by American Heart Association, Inc.