Transient Local Injury Current in Right Ventricular Electrogram After Implantable Cardioverter-Defibrillator Shock Predicts Heart Failure Progression
Larisa G. Tereshchenko, MD, PhD*, ,*,
Mitchell N. Faddis, MD, PhD,
Barry J. Fetics, MS*,
Karl E. Zelik, MS , ,
Igor R. Efimov, PhD and
Ronald D. Berger, MD, PhD*
* Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland
Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri
Biomedical Engineering Department, Washington University in St. Louis, St. Louis, Missouri
University of Michigan, Ann Arbor, Michigan
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Figure 1 Measurement of LIC After Induced VF Rescue ICD Shock
ICD = implantable cardioverter-defibrillator; LIC = local injury current; R = peak-to-peak R-wave amplitude; VF = ventricular fibrillation.
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Figure 2 RV EGMs: Control and After ICD Shock
(A) Typical post-shock implantable cardioverter-defibrillator (ICD) recording of right ventricular (RV) near-field electrogram (EGM) in control recording, and after ICD shock in patients with local injury current (A), and in patients with lack of injury (B).
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Figure 3 LIC Predicts Risk of CHF
Kaplan-Meier curves for freedom from congestive heart failure (CHF) events in patients with significant local injury current (LIC) (+) and those with the LIC (–) for all leads (A) and for newly implanted leads only (B).
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Figure 4 LIC Modifies CHF Risk After ICD Shock
Kaplan-Meier curves for freedom from CHF events in patients with and without appropriate ICD shocks at follow-up among LIC (+) patients (A), and LIC (–) patients (B). Abbreviations as in Figures 1 and 2.
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