Speckle tracking echocardiography for prediction of arrhythmias in idiopathic ventricular fibrillation.

Aims: Individuals experiencing a sudden cardiac arrest with ventricular fibrillation and no identifiable cause are diagnosed with idiopathic ventricular fibrillations (IVFs). 2D speckle tracking echocardiography (2DSTE) has been able to detect differences between IVF patients and controls. However, the association between these differences and the risk of ventricular arrhythmias (VAs) remains unknown.This study aimed to investigate whether parameters derived from myocardial deformation analysis using 2DSTE are associated with the recurrence of VA in IVF patients.

Methods and results: This single-centre, cross-sectional study enrolled IVF patients treated with an implantable cardioverter defibrillator. IVF patients were compared with healthy sex- and age-matched controls. Furthermore, IVF patients were categorized into two groups (IVF patients with or without recurrent VA) based on the recurrence of VA over a 5-year follow-up period. Left ventricular global longitudinal strain (LVGLS) and left ventricular mechanical dispersion (LVMD) were investigated using 2DSTE and compared across all groups. Fifty-six IVF patients, males 39 (69.9%), age 49 ± 15 years, and 55 controls were included. IVF patients showed significantly increased LVMD (35.78 ± 13.4 ms vs. 31.0 ± 9.8 ms; P = 0.03) and decreased LVGLS (-18.8% ± 3.0% vs. -20.5% ± 2.7%; P < 0.01) compared with controls. IVF patients with recurrent VA had significantly increased LVMD compared with IVF patients without recurrent VA (43.63 ± 13.63 vs. 33.16 ± 12.45; P = 0.02).

Conclusion: IVF patients had an increased LVMD and decreased LVGLS compared with healthy controls. Increased LVMD was significantly associated with recurrent VA in IVF patients suggesting a potential clinical value in risk stratification of VA recurrency in IVF patients.