Value of J wave in different leads for predicting the occurrence of ventricular fibrillation in patients with acute ST-segment elevation myocardial infarction
Abstract：ObjectiveTo investigate the predictive value of J wave in different leads(inferior wall, anterior wall and lateral wall) for the occurrence of shortterm ventricular fibrillation(VF) among the patients with acute STsegment elevation myocardial infarction(ASTEMI). MethodsRetrospective analysis was performed on 588 patients definitely diagnosed with ASTEMI in our hospital from January 2014 to January 2017. These patients were divided into VF group(38 cases) and nonVF group(550 cases) based on whether VF appeared on their ECGs. Basic clinical data(gender, age, history of smoking, hypertension, diabetes or dyslipidemia) and level of myocardial markers(CK, CKMB and troponin) were compared between these two groups. VF group was further divided into inferior wall, anterior wall and lateral wall groups. The relativity between ischemic J wave in different leads and the occurrence of VF was analyzed. Results(ⅰ) There was no statistically significant difference in the basic clinical data and level of myocardial markers between VF and nonVF groups(P>0.05). (ⅱ) In the VF group, J wave in inferior wall leads was observed in 23 cases(60.53%), J wave in anterior wall leads was observed in 10 cases(26.32%), and J wave in lateral wall leads was observed in 5 cases(13.16%). Among those patients with inferior wall myocardial infarction, 16(42.11%) were complicated by right ventricular myocardial infarction. According to ROC curve, for patients with J wave in different leads, the order of VF incidence from high to low was that of patients with J wave in inferior wall leads, anterior wall leads and lateral wall leads, with statistically significant differences(P<0.05). ConclusionThe appearance of J waves in different infarction sites indicates different incidences of VF. The order of VF incidence from high to low was that of patients with J wave in inferior wall leads, anterior wall leads and lateral wall leads. There will be a significant increase of VF incidence within a short time period if J wave appears in inferior wall and right ventricular leads. J wave in different leads can serve as a warning sign of VF and sudden death.
刘春露, 张树龙, 张曙影, 江雪, 金哲.
不同导联J波对急性ST段抬高型心肌梗死患者心室颤动的预测价值[J]. 实用心电学杂志, 2018, 28(4): 257-260.
LIU Chun-Lu, ZHANG Shu-Long, ZHANG Shu-Ying, JIANG Xue, JIN Zhe. Value of J wave in different leads for predicting the occurrence of ventricular fibrillation in patients with acute ST-segment elevation myocardial infarction. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2018, 28(4): 257-260.
2018, Vol. 28 
