Document Detail

Inferior and lateral electrocardiographic repolarization abnormalities in Brugada syndrome.
MedLine Citation:
PMID:  19808460     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Repolarization abnormalities in the inferior-lateral leads in Brugada syndrome (BS) have not been systematically investigated. METHODS AND RESULTS: 280 patients (age, 41+/-18 years; 168 males) with BS were screened for inferior-lateral repolarization abnormalities. The repolarization abnormalities were classified either as early repolarization pattern or coved > or = 2-mm Brugada pattern and as spontaneous or class I antiarrhythmic drug (AAD) induced. Thirty-two patients (11%) had inferior-lateral spontaneous early repolarization pattern. These patients were less likely to be asymptomatic at first presentation (13 of 32 versus 156 of 248 patients, P=0.02), and spontaneous type I ECG was more frequent among them (38% versus 21%, P=0.05). The spontaneous early repolarization pattern occurred more frequently among patients with BS than in 283 family members not having BS (11% versus 6%, P=0.03). Class I AAD administration provoked inferior-lateral coved Brugada pattern in 13 patients with BS. These patients had longer baseline PR intervals (206+/-48 versus 172+/-31 ms, P<0.001) and class I AAD-induced QRS interval prolongation (108 to 178 versus 102 ms to 131 ms, P<0.001). In 3 patients, the class I AAD-provoked coved Brugada pattern was only present in the inferior leads. CONCLUSIONS: Inferior-lateral early repolarization pattern occurs spontaneously relatively frequently in BS. These patients have a more severe phenotype. Class I AAD administration provokes inferior-lateral coved Brugada pattern in 4.6% of patients. We report for the first time 3 patients in whom the class I AAD-provoked coved Brugada pattern was only observed in the inferior leads.
Andrea Sarkozy; Gian-Battista Chierchia; Gaetano Paparella; Tim Boussy; Carlo De Asmundis; Marcus Roos; Stefan Henkens; Leonard Kaufman; Ronald Buyl; Ramon Brugada; Josep Brugada; Pedro Brugada
Publication Detail:
Type:  Journal Article     Date:  2009-02-13
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  2     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-10-07     Completed Date:  2009-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  154-61     Citation Subset:  IM    
Heart Rhythm Management Center, Universitair Ziekenhuis Brussels, Brussels, 1090-B, Belgium.
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MeSH Terms
Brugada Syndrome / diagnosis*,  epidemiology,  physiopathology*
Heart Conduction System / physiopathology*
Middle Aged
Refractory Period, Electrophysiological / physiology*
Young Adult

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