Abstract
Purpose
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 123I-meta-iodo-benzylguanidine scintigraphy (123I-MIBG SPECT), on the long-term prognosis of patients with IVF.
Methods
123I-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 123I-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 123I-MIBG uptake whereas only two episodes of monomorphic ventricular tachycardia (and no VF) occurred in a single IVF patient with normal 123I-MIBG uptake.
Conclusion
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 123I-MIBG SPECT during the long-term follow-up of these patients.
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Acknowledgements
The authors thank Mrs. Silke Schroer, Mrs. Petra Gerdes and Mrs. Christine Bätza for their excellent technical assistance. This work was supported in part by grants from the Deutsche Forschungsgemeinschaft (DFG), Bonn, Germany, Sonderforschungsbereich 556 (Projects C4 and C1).
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The first two named authors contributed equally to this work.
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Paul, M., Schäfers, M., Kies, P. et al. Impact of sympathetic innervation on recurrent life-threatening arrhythmias in the follow-up of patients with idiopathic ventricular fibrillation. Eur J Nucl Med Mol Imaging 33, 866–870 (2006). https://doi.org/10.1007/s00259-005-0061-7
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DOI: https://doi.org/10.1007/s00259-005-0061-7