title: Inferior J waves in patients with vasospastic angina might be a risk factor for ventricular fibrillation.
abstract: BACKGROUND
  There is little information about the relationship between J waves and the occurrence of ventricular fibrillation (VF) in patients with vasospastic angina (VSA). The present study aimed to assess the incidence of J waves and the occurrence of VF in patients with VSA.
  
  
  METHODS
  The subjects consisted of 62 patients with VSA diagnosed by acetylcholine provocation tests in our institution from 2002 to 2014. We investigated the VF events, prevalence of J waves, and relationship between the VF events and J waves.
  
  
  RESULTS
  J waves were observed in 16 patients (26%) and VF events were documented in 11 (18%). The incidence of VF in the patients with J waves was significantly higher than that in those without J waves (38% vs 11%, p=0.026). J waves were observed in the inferior leads in 14 patients, lateral leads in 5, and anterior leads in 3. A univariate analysis indicated that the incidence of VF in the inferior leads of J wave positive patients (46%=6/14) was significantly (p=0.01) higher than that in the inferior leads of J wave negative patients (10%=5/48). The J waves in the anterior and/or lateral leads were not related to the incidence of VF. Notched type and slurred type J waves were not associated with VF. A multivariate analysis revealed that J waves in VSA patients were associated with VF [odds ratio (OR) 6.41, 95% confidence interval (CI) 1.37-29.93, p=0.02] and organic stenosis (OR 6.98, 95% CI 1.39-35.08, p=0.02). Further, J waves in the inferior leads were strongly correlated with VF (OR 11.85, 95% CI 2.05-68.42, p=0.006).
  
  
  CONCLUSIONS
  The results suggest that the existence of J waves, especially in the inferior leads, might be a risk factor for VF in VSA patients.
authors.affiliation: Division of Cardiology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Fumimoto
authors.affiliation: Division of Cardiology, Yamaguchi University Graduate School of Medicine, Ube, Japan. Electronic address: tueyama@yamaguchi-u.ac.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ueyama
authors.affiliation: Division of Cardiology and Faculty of Health Sciences, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Shimizu
authors.affiliation: Division of Cardiology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Yoshiga
authors.affiliation: Division of Cardiology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Ono
authors.affiliation: Division of Cardiology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Kato
authors.affiliation: Division of Cardiology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Ishiguchi
authors.affiliation: Division of Cardiology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Okamura
authors.affiliation: Division of Cardiology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Jutaro
authors.initials: J
authors.lastname: Yamada
authors.affiliation: Division of Cardiology, Yamaguchi University Graduate School of Medicine, Ube, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Yano
mesh_terms: D000109:Acetylcholine; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000453:epidemiology* / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014693:Ventricular Fibrillation / Q000453:epidemiology* / Q000503:physiopathology*
chemical_list: D000109:Acetylcholine
keywords: J waves; Vasospastic angina; Ventricular fibrillation