| Noninvasive risk stratification of subjects with a Brugada-type electrocardiogram and no history of cardiac arrest. | |
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MedLine Citation:
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PMID: 16255748 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Recent studies suggest that the Brugada-type electrocardiogram (ECG) is much more prevalent than the manifest Brugada syndrome. Although invasive electrophysiologic investigations have been proposed as a risk stratifier, their value is controversial, and alternative noninvasive techniques may be preferred. We sought a noninvasive strategy to detect a high-risk group in a long-term follow-up study of subjects with a Brugada-type ECG, and no history of cardiac arrest. METHODS: This study enrolled 124 consecutive subjects with a Brugada-type ECG. Prognostic indices included: age, sex, a family history of sudden death, syncopal episodes, a spontaneous coved-type ST-segment elevation, maximal magnitude of ST-segment elevation, a spontaneous change in ST segment, a mean QRS duration, maximal QT interval, QT dispersion, late potentials (LP) by signal-averaged ECG, and microvolt T-wave alternans. RESULTS: Of the 124 subjects, 20 consenting subjects had an implantable defibrillator before follow-up. During a 40 +/- 19-month follow-up, 12 subjects (9.7%) reached one of the endpoints (sudden death or ventricular tachyarrhythmia). Of the 12 risk indices, a family history of sudden death, syncopal episodes, a spontaneous coved-type ST-segment elevation, a spontaneous change in ST segment, and LP had significant values. In multivariate analysis, a spontaneous change in ST segment had the most significance (a relative hazard, 9.2; P = 0.036). Combined assessment of this index and other significant indices obtained higher positive predictive values (43-71%). CONCLUSIONS: A spontaneous change in ST segment is associated with the highest risk for subsequent events in subjects with a Brugada-type ECG. The presence of syncopal episodes, a history of familial sudden death, and/or LP may increase its value. |
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Authors:
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Takanori Ikeda; Mitsuaki Takami; Kaoru Sugi; Yuka Mizusawa; Harumizu Sakurada; Hideaki Yoshino |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc Volume: 10 ISSN: 1082-720X ISO Abbreviation: Ann Noninvasive Electrocardiol Publication Date: 2005 Oct |
Date Detail:
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Created Date: 2005-10-31 Completed Date: 2006-01-20 Revised Date: 2008-03-10 |
Medline Journal Info:
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Nlm Unique ID: 9607443 Medline TA: Ann Noninvasive Electrocardiol Country: United States |
Other Details:
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Languages: eng Pagination: 396-403 Citation Subset: IM |
Affiliation:
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Cardiac Electrophysiology Lab, Second Department of Internal Medicine, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan. iket@kyorin-u.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Age Distribution Bundle-Branch Block / diagnosis*, mortality* Comorbidity Diagnosis, Computer-Assisted / methods* Disease-Free Survival Electrocardiography / methods, statistics & numerical data* Female Heart Arrest / diagnosis, mortality Humans Japan / epidemiology Male Prevalence Prognosis Risk Assessment / methods* Risk Factors Sex Distribution Survival Rate Ventricular Fibrillation / diagnosis*, mortality* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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