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RR interval variability in the evaluation of ventricular tachycardia and effects of implantable cardioverter defibrillator therapy
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  • Keita Tsukahara,
  • Yasushi Oginosawa,
  • Yoshihisa Fujino,
  • Toshinobu Honda,
  • Kan Kikuchi,
  • Masatsugu Nozoe,
  • Takayuki Uchida,
  • Hitoshi Minamiguchi,
  • Koichiro Sonoda,
  • Masahiro Ogawa,
  • Takeshi Ideguchi,
  • Yoshihisa Kizaki,
  • Toshihiro Nakamura,
  • Kageyuki Oba,
  • Satoshi Higa,
  • Keiki Yoshida,
  • Keishiro Yagyu,
  • Taro Miyamoto,
  • Yamagishi Yasunobu,
  • Hisaharu Ohe,
  • Ritsuko Kohno,
  • Yutaka Otsuji,
  • Haruhiko Abe
Keita Tsukahara
University of Occupational and Environmental Health Japan
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Yasushi Oginosawa
Sangyo Ika Daigaku
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Yoshihisa Fujino
University of Occupational and Environmental Health, Japan,
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Toshinobu Honda
Kumamoto Junkanki Hospital
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Kan Kikuchi
Japan Community Healthcare Organization, Kyushu Hospital
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Masatsugu Nozoe
Saiseikai Fukuoka General Hospital
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Takayuki Uchida
Iizuka Hospital
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Hitoshi Minamiguchi
Osaka University Graduate School of Medicine
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Koichiro Sonoda
Sasebo City General Hospital
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Masahiro Ogawa
Fukuoka University
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Takeshi Ideguchi
University of Miyazaki
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Yoshihisa Kizaki
Hakujujikai Sasebo Chuo Hospital
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Toshihiro Nakamura
National Hospital Organisation Kyushu Medical Center
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Kageyuki Oba
Yuai Medical Center
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Satoshi Higa
University of the Ryukyus
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Keiki Yoshida
Saga-ken Medical Centre Koseikan
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Keishiro Yagyu
University of Occupational and Environmental Health Japan
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Taro Miyamoto
University of Occupational and Environmental Health Japan
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Yamagishi Yasunobu
University of Occupational and Environmental Health Hospital
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Hisaharu Ohe
University of Occupational and Environmental Health Japan
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Ritsuko Kohno
University of Occupational and Environmental Health, Kitakyushu, Japan
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Yutaka Otsuji
University of Occupational and Environmental Health, Japan,
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Haruhiko Abe
University of Occupational and Environmental Health, Japan
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Abstract

Introduction: An implantable cardioverter defibrillator (ICD) is the most reliable therapeutic device for preventing sudden cardiac death in patients with sustained ventricular tachycardia (VT). Regarding the effectiveness of the ICD, targeted VT is defined based on the tachyarrhythmia cycle length. However, variation of the RR interval variability of VTs does occur. A few studies reported on VT characteristics and effects of ICD therapy according to RR interval variability. This study aimed to identify the clinical characteristics of VTs and effects of ICD therapy according to RR interval variability. Methods: We analyzed 821 VT episodes in 69 of 185 patients treated with ICDs or cardiac resynchronization therapy defibrillators. VTs were classified as regular or irregular based on RR interval variability. We evaluated successful termination using anti-tachycardia pacing (ATP)/shock therapy, spontaneous termination, and acceleration between regular and irregular VTs. Reproducibility of the RR interval variability in one VT episode and within an individual with recurrent VT episodes was evaluated. Results: Regular VT was significantly more successfully terminated than irregular VT by ATP therapy. There was no significant difference in shock therapy or VT acceleration, irrespective of the variability of the VT cycle length. Spontaneous termination of VT occurred significantly more often in irregular than in regular VT. Reproducibility of RR interval variability in an episode and individual was 89% and 73%, respectively. Conclusion: ATP therapy showed greater effectiveness for regular than for irregular VT. Spontaneous termination was more common in irregular than in regular VT. RR interval variability of VTs is reproducible.