OBJECTIVETo explore the association between clinical and ECG characteristics and prognoses in patients with idiopathic ventricular fibrillation (VF).

METHODSWe reviewed the data from 21 VF patients [male 47.6%, mean age (38.5 ± 19.0) years] with first event of VF, all patients were resuscitated after cardiac arrest and diagnosed as idiopathic VF. The prevalence of J wave was assessed and patients were divided into J wave positive (J+ group) and negative group (J- group). The end point was death or syncope from arrhythmia, and recorded VF recurrence during the follow-up.

RESULTSJ wave was frequent in subjects with idiopathic VF (71.4%). Among patients in the J+ group (15 cases), notch on the QRS wave was found in 7 subjects (46.7%), these patients were more likely to suffer from the sudden cardiac arrest during sleep at early morning than those with J wave but without notch on the QRS wave. Two patients dead suddenly in the J+ group and 1 dead from embolism in the J- group during follow-up [mean (42.4 ± 39.9) months]. The mean year-onset of VF or syncope was significantly higher in the J+ group than in the J-group [(1.3 ± 0.5) episodes/year vs. (0.4 ± 0.3) episodes/year, P < 0.01]. J wave positive was also associated with an increased risk of VF recurrence (RR 1.9, 95%CI 1.1 to 2.9, P = 0.03).

CONCLUSIONJ wave prevalence is high in patients with history of idiopathic VF, and positive J wave is associated with high risk of recurrence of sudden cardiac death.