title: Impact of sympathetic innervation on recurrent life-threatening arrhythmias in the follow-up of patients with idiopathic ventricular fibrillation.
abstract: 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.
authors.affiliation: Department of Cardiology and Angiology, Hospital of the University of Münster, Münster, Germany. mapaul@uni-muenster.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Paul
authors.forename: Michael
authors.initials: M
authors.lastname: Schäfers
authors.forename: Peter
authors.initials: P
authors.lastname: Kies
authors.forename: Tayfun
authors.initials: T
authors.lastname: Acil
authors.forename: Klaus
authors.initials: K
authors.lastname: Schäfers
authors.forename: Günter
authors.initials: G
authors.lastname: Breithardt
authors.forename: Otmar
authors.initials: O
authors.lastname: Schober
authors.forename: Thomas
authors.initials: T
authors.lastname: Wichter
mesh_terms: 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
chemical_list: D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine