Impact of sympathetic innervation on recurrent life-threatening arrhythmias in the follow-up of patients with idiopathic ventricular fibrillation.
OBJECTIVE
Idiopathic ventricular fibrillation (IVF) is defined as VF in the absence of any identifiable structural or functional cardiac disease. The underlying pathophysiological mechanisms are unknown. This study was performed to investigate the potential impact of sympathetic dysfunction, assessed by (123)I-meta-iodo-benzylguanidine scintigraphy ((123)I-MIBG SPECT), on the long-term prognosis of patients with IVF.


METHODS
(123)I-MIBG SPECT was performed in 20 patients (mean age 37+/-13 years) with IVF. Mean follow-up of patients after study entry was 7.2+/-1.5 years (range 4.9-10.5 years). Ten patients (five men, five women; mean age 43+/-12 years; p=NS versus study group) with medullary carcinoma of the thyroid gland served as an age-matched control group.


RESULTS
Abnormal (123)I-MIBG uptake was observed in 13 patients (65%). During follow-up, 18 episodes of VF/fast polymorphic ventricular tachycardias occurred in four IVF patients with abnormal (123)I-MIBG uptake whereas only two episodes of monomorphic ventricular tachycardia (and no VF) occurred in a single IVF patient with normal (123)I-MIBG uptake.


CONCLUSIONS
Impairment of sympathetic innervation may indicate a higher risk of future recurrent episodes of life-threatening ventricular tachyarrhythmias in patients with IVF. Studies in larger cohorts are required to validate the significance of (123)I-MIBG SPECT during the long-term follow-up of these patients.
Paul
Matthias
M
Department of Cardiology and Angiology, Hospital of the University of Münster, Münster, Germany. mapaul@uni-muenster.de
Schäfers
Michael
M
Kies
Peter
P
Acil
Tayfun
T
Schäfers
Klaus
K
Breithardt
Günter
G
Schober
Otmar
O
Wichter
Thomas
T
D019797:3-Iodobenzylguanidine; D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D009202:Cardiomyopathies / Q000150:complications / Q000000981:diagnostic imaging*; D003422:Critical Care / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000000981:diagnostic imaging*; D011379:Prognosis; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012008:Recurrence; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013564:Sympathetic Nervous System / Q000000981:diagnostic imaging*; D014693:Ventricular Fibrillation / Q000000981:diagnostic imaging* / Q000209:etiology
D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine