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Europace Advance Access originally published online on September 14, 2007
Europace 2007 9(11):1054-1058; doi:10.1093/europace/eum194
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© The European Society of Cardiology 2007. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

ICDS

Differences in the characteristics of induced and spontaneous episodes of ventricular fibrillation

Nigel A. Lever1, Emma G. Newall2 and Peter D. Larsen2,*

1 Department of Medicine University of Auckland, Auckland, New Zealand; 2 Department of Surgery and Anaesthesia, Wellington School of Medicine, Wellington, New Zealand

Aims: The degree of organization of ventricular fibrillation (VF) can be examined in terms of the regularity of the electrical activity within the ventricle. Using electrograms (EGMs) stored within implanted cardioverter defibrillators (ICDs), we examined the hypothesis that the degree of organization, or regularity, was different if the VF was induced by electrical stimulation as opposed to occurring clinically due to ischemia or scar.

Methods and results: We compared the statistical characteristics of EGMs recorded by ICDs during spontaneous episodes with those induced during device testing in the laboratory in nine subjects. Regularity of the VF EGM signals was quantified using autocorrelation, Shannon entropy (derived from cycle to cycle activation complexes), and Kolmogorov entropy (derived from eight second long episodes of VF). All three measurements showed a statistically greater degree of regularity for induced VF than in spontaneous episodes.

Conclusion: Analysis of VF EGMs using these techniques is novel and robust, providing a new way for assessing electrical organization during VF. The clinical significance and utility of differences in VF waveform regularity is unclear at this stage.

Key Words: Implanted cardioverter defibrillator, Ventricular fibrillation

* Corresponding author. Tel: +64 4 385 5999; fax: +64 4 389 5318. E-mail address: peter.larsen{at}otago.ac.nz

Manuscript submitted 22 May 2007. Accepted after revision 13 August 2007.


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