Prevalence of ventricular parasystole in patients with cardiac sarcoidosis: correlation between parasystole and inflammation in ventricular fibrillation
Background Ventricular parasystole is strongly associated with ventricular fibrillation (VF) in patients with non-ischaemic cardiomyopathy. However, the relationship between ventricular parasystole and cardiac sarcoidosis (CS) remains unclear. The purpose of this study was to examine the prevalence...
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BMJ Publishing Group
2025-04-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/12/1/e003196.full |
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| author | Takeshi Aiba Kengo Kusano Kohei Ishibashi Tsukasa Kamakura Mitsuru Wada Yuko Inoue Koji Miyamoto Satoshi Nagase Tetsuya Fukuda Emi Tateishi Reina Tonegawa-Kuji Yuichiro Miyazaki Akinori Wakamiya Nobuhiko Ueda Kenzaburo Nakajima Takashi Ikee Toshihiro Nakamura Satoshi Oka |
| author_facet | Takeshi Aiba Kengo Kusano Kohei Ishibashi Tsukasa Kamakura Mitsuru Wada Yuko Inoue Koji Miyamoto Satoshi Nagase Tetsuya Fukuda Emi Tateishi Reina Tonegawa-Kuji Yuichiro Miyazaki Akinori Wakamiya Nobuhiko Ueda Kenzaburo Nakajima Takashi Ikee Toshihiro Nakamura Satoshi Oka |
| author_sort | Takeshi Aiba |
| collection | DOAJ |
| description | Background Ventricular parasystole is strongly associated with ventricular fibrillation (VF) in patients with non-ischaemic cardiomyopathy. However, the relationship between ventricular parasystole and cardiac sarcoidosis (CS) remains unclear. The purpose of this study was to examine the prevalence of parasystole in patients with CS.Methods This was a retrospective observational study of 214 consecutive patients diagnosed with CS (mean age: 69±12 years, 104 males, median follow-up period: 6.8 years (IQR: 3.2–10.7) in our centre. We investigated parasystole in the patients who developed ventricular arrhythmia (VA) using 9886 ECGs, 280 Holter ECGs and 6391 implantable cardioverter defibrillator interrogation records. Classic parasystole was defined as three ventricular ectopic beats with the same morphology, occurring at integer-multiple intervals but with different coupling intervals (CI) on ECG. New parasystole was defined as two ventricular ectopic beats with a CI difference of more than 120 ms. We also analysed the correlation between inflammation sites and parasystole morphology observed on a 12-lead ECG.Results VA was identified in 95 patients (33.7%), and 22 developed VF (23.2%). Parasystole was observed in 12 of the 22 patients with VF (classic: 5, new: 7), 20 of 73 with ventricular tachycardia (classic: 5, new: 15) and 44 of 118 without VA (classic: 16, new: 28). Parasystole was significantly more common in the VF group than in the non-VF group (p=0.049). The site of inflammation observed on 18F-fluorodeoxyglucose positron emission tomography performed within 3 months after the development of VA and the origin of parasystole matched in all four patients with VF who had 12-lead ECG records of parasystole. Inflammation was correlated with the origin of parasystole.Conclusion Ventricular parasystole was detected in one-third of patients with CS in this study, especially those with VF. The presence of parasystole and inflammation may predict the occurrence of VF in patients with CS. |
| format | Article |
| id | doaj-art-c845c2733b1f45bca90931f7d627c489 |
| institution | DOAJ |
| issn | 2053-3624 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMJ Publishing Group |
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| series | Open Heart |
| spelling | doaj-art-c845c2733b1f45bca90931f7d627c4892025-08-20T03:06:28ZengBMJ Publishing GroupOpen Heart2053-36242025-04-0112110.1136/openhrt-2025-003196Prevalence of ventricular parasystole in patients with cardiac sarcoidosis: correlation between parasystole and inflammation in ventricular fibrillationTakeshi Aiba0Kengo Kusano1Kohei Ishibashi2Tsukasa Kamakura3Mitsuru Wada4Yuko Inoue5Koji Miyamoto6Satoshi Nagase7Tetsuya Fukuda8Emi Tateishi9Reina Tonegawa-Kuji10Yuichiro Miyazaki11Akinori Wakamiya12Nobuhiko Ueda13Kenzaburo Nakajima14Takashi Ikee15Toshihiro Nakamura16Satoshi Oka17Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, JapanDepartment of General Internal Medicine 3, Kawasaki Medical School General Medical Center, Okayama, JapanDepartment of Radiology, National Cerebral and Cardiovascular Center Hospital, Suita, JapanDepartment of Radiology, National Cerebral and Cardiovascular Center Hospital, Suita, JapanGenomic Medicine Institute, Lerner research institute, Cleveland Clinic, Cleveland, Ohio, USADepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, JapanBackground Ventricular parasystole is strongly associated with ventricular fibrillation (VF) in patients with non-ischaemic cardiomyopathy. However, the relationship between ventricular parasystole and cardiac sarcoidosis (CS) remains unclear. The purpose of this study was to examine the prevalence of parasystole in patients with CS.Methods This was a retrospective observational study of 214 consecutive patients diagnosed with CS (mean age: 69±12 years, 104 males, median follow-up period: 6.8 years (IQR: 3.2–10.7) in our centre. We investigated parasystole in the patients who developed ventricular arrhythmia (VA) using 9886 ECGs, 280 Holter ECGs and 6391 implantable cardioverter defibrillator interrogation records. Classic parasystole was defined as three ventricular ectopic beats with the same morphology, occurring at integer-multiple intervals but with different coupling intervals (CI) on ECG. New parasystole was defined as two ventricular ectopic beats with a CI difference of more than 120 ms. We also analysed the correlation between inflammation sites and parasystole morphology observed on a 12-lead ECG.Results VA was identified in 95 patients (33.7%), and 22 developed VF (23.2%). Parasystole was observed in 12 of the 22 patients with VF (classic: 5, new: 7), 20 of 73 with ventricular tachycardia (classic: 5, new: 15) and 44 of 118 without VA (classic: 16, new: 28). Parasystole was significantly more common in the VF group than in the non-VF group (p=0.049). The site of inflammation observed on 18F-fluorodeoxyglucose positron emission tomography performed within 3 months after the development of VA and the origin of parasystole matched in all four patients with VF who had 12-lead ECG records of parasystole. Inflammation was correlated with the origin of parasystole.Conclusion Ventricular parasystole was detected in one-third of patients with CS in this study, especially those with VF. The presence of parasystole and inflammation may predict the occurrence of VF in patients with CS.https://openheart.bmj.com/content/12/1/e003196.full |
| spellingShingle | Takeshi Aiba Kengo Kusano Kohei Ishibashi Tsukasa Kamakura Mitsuru Wada Yuko Inoue Koji Miyamoto Satoshi Nagase Tetsuya Fukuda Emi Tateishi Reina Tonegawa-Kuji Yuichiro Miyazaki Akinori Wakamiya Nobuhiko Ueda Kenzaburo Nakajima Takashi Ikee Toshihiro Nakamura Satoshi Oka Prevalence of ventricular parasystole in patients with cardiac sarcoidosis: correlation between parasystole and inflammation in ventricular fibrillation Open Heart |
| title | Prevalence of ventricular parasystole in patients with cardiac sarcoidosis: correlation between parasystole and inflammation in ventricular fibrillation |
| title_full | Prevalence of ventricular parasystole in patients with cardiac sarcoidosis: correlation between parasystole and inflammation in ventricular fibrillation |
| title_fullStr | Prevalence of ventricular parasystole in patients with cardiac sarcoidosis: correlation between parasystole and inflammation in ventricular fibrillation |
| title_full_unstemmed | Prevalence of ventricular parasystole in patients with cardiac sarcoidosis: correlation between parasystole and inflammation in ventricular fibrillation |
| title_short | Prevalence of ventricular parasystole in patients with cardiac sarcoidosis: correlation between parasystole and inflammation in ventricular fibrillation |
| title_sort | prevalence of ventricular parasystole in patients with cardiac sarcoidosis correlation between parasystole and inflammation in ventricular fibrillation |
| url | https://openheart.bmj.com/content/12/1/e003196.full |
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