Abstract 17091: Rotor Prevalence and Stability Predict Longer Duration of Self-terminating Ventricular Fibrillation Episodes
Introduction: Ventricular fibrillation (VF) is an important mediator of sudden cardiac death, yet the perpetuating mechanisms for VF remain unclear.
Methods: In 26 consecutive patients (age 64 ± 10 years) presenting for ventricular arrhythmia ablation, 64-electrode basket catheters were inserted into the left and right ventricles, and VF was induced according to an IRB-approved research study. Using proprietary software (RhythmView, Topera, Palo Alto, California), computational VF phase movies were made and analyzed. Each VF cycle in non-sustained episodes was characterized as either a rotor, focal, or disorganized activation pattern. The proportion of rotor activation was then correlated to the duration of the VF episode using linear regression analysis.
Results: There were 35 total episodes of VF, with 20 episodes requiring defibrillation for termination and 15 episodes that were self-terminating. Mean duration of self-terminating VF episodes was 3.5 ± 1.3 seconds. There was a significant correlation between both rotor prevalence (R2 = 0.29, p = 0.039) (Figure 1A) and rotor stability (R = 0.50, p = 0.0031) (Figure 1B) with the duration of the self-terminating VF episode.
Conclusions: These data show that rotor activity is increasingly prevalent in longer episodes of VF and suggest that rotors are mechanistically important in VF perpetuation. Future studies should investigate whether rotor modulation decreases VF susceptibility.
Author Disclosures: J. Hayase: None. Y. Faiwiszewski: None. S. Vampola: None. L. Kazmirczak: None. T. Baykaner: None. G. Ho: None. G. Lalani: None. A. Schricker: None. S. Narayan: Honoraria; Modest; Medtronic, Biotronik, Janssen. Research Grant; Significant; NIH. Ownership Interest; Significant; Topera, Inc.. Consultant/Advisory Board; Significant; Topera, Inc. D. Krummen: Research Grant; Significant; AHA, NIH. Honoraria; Modest; Boston Scientific, Medtronic, St. Jude, Biotronik, Biosense-Webster.
- © 2014 by American Heart Association, Inc.