Affiliation:
1. Division of Arrhythmia and Electrophysiology Department of Cardiovascular Medicine National Cerebral and Cardiovascular Center Suita Japan
2. Department of Cardiovascular Medicine Nippon Medical School Tokyo Japan
Abstract
Background
Epicardial mapping can reveal low‐voltage areas on the right ventricular outflow tract in patients with Brugada syndrome with several ventricular fibrillation (
VF
) episodes. A type 1
ECG
is associated with an abnormal electrogram on right ventricular outflow tract epicardium. This study investigated the clinical significance of the amplitude of type 1
ECGs
in patients with Brugada syndrome.
Methods and Results
In 209 patients with Brugada syndrome with a spontaneous type 1
ECG
(26 resuscitated from
VF
, 54 with syncope, and 129 asymptomatic), the amplitude of the
ECG
in leads exhibiting type 1 was measured among V1 to V3 leads positioned in the standard and upper 1 and 2 intercostal spaces. The number of ECG leads exhibiting type 1 did not differ among groups. The averaged amplitude of type 1
ECG
was, however, significantly smaller in the group resuscitated from
VF
than in the asymptomatic group (
P
<0.05). Moreover, the minimum amplitude of type 1
ECG
was significantly smaller in the group resuscitated from
VF
than in the group with syncope and the asymptomatic group (
P
<0.05 and
P
<0.01, respectively). During follow‐up (56±48 months),
VF
occurred in 29 patients. Kaplan‐Meier analysis revealed that patients with the minimum amplitude of type 1
ECG
lower than or at the median value had a higher incidence of
VF
(log‐rank test,
P
<0.01). In multivariate analysis, syncope, past
VF
episode, and minimum amplitude of type 1
ECG
≤0.8
mV
were independent predictors of
VF
events during follow‐up.
Conclusions
Low‐voltage type 1
ECG
is highly and independently related to fatal ventricular tachyarrhythmia in patients with Brugada syndrome.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
11 articles.
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