Document Detail

Role of signal-averaged electrocardiograms for predicting the inducibility of ventricular fibrillation in the syndrome consisting of right bundle branch block and ST segment elevation in leads V1-V3.
MedLine Citation:
PMID:  12227712     Owner:  NLM     Status:  MEDLINE    
Right bundle branch block and ST segment elevation (RBBB-STE) in the right precordial leads have been reported as a distinct clinical and electrocardiographic syndrome in patients prone to ventricular fibrillation (VF) in the absence of structural heart disease (Brugada syndrome). The purpose of the study was to investigate the role of signal averaged electrocardiogram (SAECG) in identifying patients at high risk among asymptomatic RBBB-STE patients. Thirteen patients with the RBBB-STE ECG were identified. Symptoms were: syncope (n=3, cases 1, 3, and 11), atypical chest pain (n=3, cases 4, 10, and 12) and palpitations (n=2, cases 6, and 7). The other 5 patients were asymptomatic. SAECG and programmed electrical stimulation (PES) were conducted in all patients. Body surface late potentials (LPs) were present in 7 of 13 patients before PES. Vf was induced in 6 of 7 LP positive patients. Vf was induced in 3 of 6 LP negative patients, but LP became positive in 2 of 3 patients in whom Vf was induced. One patient with syncope due to VF (case 1), 1 patient without symptoms who died suddenly during follow up (case 2), and 1 asymptomatic patient (case 9) showed reproducibly positive LP. In a patient (case 9) with positive LP at baseline, LP transiently became negative during follow up. In RBBB-STE patients, reproducibly positive LP is at risk for malignant ventricular arrhythmias and sudden death. Repeated SAECG recording may be useful for screening high-risk patients who should receive electrophysiological study among asymptomatic RBBB-STE patients.
Riko Masaki; Ichiro Watanabe; Toshiko Nakai; Kazuhiko Kondo; Naohiro Oshikawa; Hidezou Sugimura; Kimie Okubo; Toshiaki Kojima; Satoshi Saito; Yukio Ozawa; Katsuo Kanmatsuse
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Japanese heart journal     Volume:  43     ISSN:  0021-4868     ISO Abbreviation:  Jpn Heart J     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-09-13     Completed Date:  2002-10-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0401175     Medline TA:  Jpn Heart J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  367-78     Citation Subset:  IM    
Second Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
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MeSH Terms
Body Surface Potential Mapping
Bundle-Branch Block / physiopathology*,  therapy
Chest Pain / complications
Defibrillators, Implantable
Electric Stimulation
Middle Aged
Syncope / complications
Ventricular Fibrillation / physiopathology*

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