Document Detail

Decreased nocturnal standard deviation of averaged NN intervals. An independent marker to identify patients at risk in the Brugada Syndrome.
MedLine Citation:
PMID:  14613743     Owner:  NLM     Status:  MEDLINE    
AIMS: Risk-stratification of asymptomatic Brugada Syndrome (BS) patients remains a key-issue. A typical spontaneous BS-ECG pattern and ventricular tachycardia (VT)/ventricular fibrillation (VF) inducibility are two recognized risk markers. The aim of the study was to identify additional risk markers in asymptomatic BS. METHODS AND RESULTS: We have compared Holter recordings in symptomatic and in asymptomatic patients with BS. Heart rate variability (HRV), QT-interval rate-dependence and ST-segment elevation (ST-SE) were analysed. The study population included 47 BS patients (M=36, mean age=45+/-13 years) with a malignant ventricular arrhythmia in 11 cases, an unexplained syncope in 10 cases and no symptoms in the remaining 26 cases. A typical spontaneous BS-ECG was present in 21 cases and a drug-induced BS-ECG in 26 cases. A downward trend of the time domain variables of HRV was observed. During the nocturnal period, standard deviation (SD) of the 5min averaged NN intervals (SDANN) (46+/-13 vs 57+/-18ms, P=0.02) and ultra low frequency component (3287+/-2312 vs 5030+/-3270 ms(2), P=0.04) were significantly lower in symptomatic versus asymptomatic patients. In contrast, no difference was found in QT-interval rate dependence and in ST-SE. At multivariate logistic regression, VT/VF inducibility, typical spontaneous BS-ECG and a decreased nocturnal SDANN were associated with arrhythmic events (P=0.003). CONCLUSIONS: A decreased nocturnal SDANN was an independent marker of arrhythmic events in these BS patients.
Jean-Sylvain Hermida; Antoine Leenhardt; Bruno Cauchemez; Isabelle Denjoy; Geneviève Jarry; Fréderique Mizon; Paul Milliez; Jean-Luc Rey; Philippe Beaufils; Philippe Coumel
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  European heart journal     Volume:  24     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-11-17     Completed Date:  2004-02-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  2061-9     Citation Subset:  IM    
Centre Hospitalier Universitaire, Amiens, France.
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MeSH Terms
Bundle-Branch Block / diagnosis*,  physiopathology
Circadian Rhythm*
Death, Sudden, Cardiac / prevention & control*
Electrocardiography, Ambulatory / methods
Electrophysiologic Techniques, Cardiac
Logistic Models
Middle Aged
Risk Assessment / methods
Risk Factors
Signal Processing, Computer-Assisted
Ventricular Fibrillation / diagnosis

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