Coexistence of atrioventricular accessory pathways and drug‐induced type 1 Brugada pattern

Hasdemir, Can; Juang, Jimmy Jyh-Ming; Köse, Sedat; Kocabaş, Umut; Orman, Mehmet; Payzın, Serdar; Şahin, Hatice; Celen, Candan; Özcan, Emin Evren; Chen, Yi Jen; Gündüz, Ramazan; Turan, Oğuzhan Ekrem; Senol, Oktay; Burashnikov, Elena; Antzelevitch, Charles

doi:10.1111/pace.13414

Cited by 14 publications

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“…It should be recognized that there is a potential high rate of false positives, as data on the specificity and sensitivity of the test are not available, and a positive ECG may be induced in 4-5% of normal subjects. 286,361 In the pediatric age group, a negative test may convert to a positive test after puberty. 362 Long QT syndrome may also be unmasked by standing, exercise test, epinephrine test, or mental stress test.…”

Section: Synopsismentioning

confidence: 99%

2020 APHRS/HRS expert consensus statement on the investigation of decedents with sudden unexplained death and patients with sudden cardiac arrest, and of their families

et al. 2021

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This international multidisciplinary document intends to provide clinicians with evidence-based practical patient-centered recommendations for evaluating patients and decedents with (aborted) sudden cardiac arrest and their families. The document includes a framework for the investigation of the family allowing steps to be taken, should an inherited condition be found, to minimize further events in affected relatives. Integral to the process is counseling of the patients and families, not only because of the emotionally charged subject, but because finding (or not finding) the cause of the arrest may influence management of family members. The formation of multidisciplinary teams is essential to provide a complete service to the patients and their families, and the varied expertise of the writing committee was formulated to reflect this need. The document sections were Developed in partnership with and endorsed by the Asia Pacific Heart Rhythm Society (APHRS) and the Heart Rhythm Society (HRS). Developed in collaboration with and endorsed by the Association for European Cardiovascular Pathology (AECVP), the European Society of Human Genetics (ESHG), the Latin American Heart Rhythm Society (LAHRS), the National Society of Genetic Counselors (NSGC), and the Pediatric and Congenital Electrophysiology Society (PACES). Developed in collaboration with the European Heart Rhythm Association (EHRA). For copies of this document, please contact the Elsevier Inc. Reprint Department

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Section: Synopsismentioning

confidence: 99%

2020 APHRS/HRS expert consensus statement on the investigation of decedents with sudden unexplained death and patients with sudden cardiac arrest, and of their families

et al. 2021

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“…One‐year prevalence of migraine is 14.4% worldwide 7 . We have previously reported high 1‐year prevalence of migraine in patients with AVNRT and AV‐APs associated with DI‐type 1 BrP 3,4 . In view of this observation, we extrapolated this finding to our BrS/DI‐type 1 BrP cohort.…”

Section: Introductionmentioning

confidence: 82%

“…7 We have previously reported high 1-year prevalence of migraine in patients with AVNRT and AV-APs associated with DItype 1 BrP. 3,4 In view of this observation, we extrapolated this finding to our BrS/DI-type 1 BrP cohort. The present study was designed to determine the lifetime prevalence of migraine in patients with BrS/DI-type 1 BrP and control group, to investigate the demographic and clinical characteristics, and to identify subset of clinical variables to predict underlying BrS/DI-type 1 BrP among migraineurs.…”

Section: Introductionmentioning

confidence: 92%

“…2 Drug-induced type 1 Brugada electrocardiographic (ECG) pattern (DI-type 1 BrP) has been shown to be associated with atrial arrhythmias, atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular accessory pathways (AV-APs) in particular. 3,4 Migraine is a common, multifactorial primary headache disorder with a strong genetic component. 5,6 One-year prevalence of migraine is 14.4% worldwide.…”

Section: Introductionmentioning

confidence: 99%

“…Type‐1 (“coved type”) ST‐segment elevation is considered diagnostic of BrS and it is present either spontaneously or induced by fever or by sodium channel blockers 2 . Drug‐induced type 1 Brugada electrocardiographic (ECG) pattern (DI‐type 1 BrP) has been shown to be associated with atrial arrhythmias, atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular accessory pathways (AV‐APs) in particular 3,4 …”

Section: Introductionmentioning

confidence: 99%

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Recognition and clinical implications of high prevalence of migraine in patients with Brugada syndrome and drug‐induced type 1 Brugada pattern

Hasdemir

Gökçay

Orman

et al. 2020

Cardiovasc electrophysiol

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Introduction: We have previously reported high 1-year prevalence of migraine in patients with atrial arrhythmias associated with DI-type 1 BrP. The present study was designed to determine the lifetime prevalence of migraine in patients with Brugada syndrome (BrS) or drug-induced type 1 Brugada pattern (DI-type 1 BrP) and control group, to investigate the demographic and clinical characteristics, and to identify clinical variables to predict underlying BrS/DI-type 1 BrP among migraineurs. Methods and Results: Lifetime prevalence of migraine and migraine characteristics were compared between probands with BrS/DI-type 1 BrP (n = 257) and control group (n = 370). Lifetime prevalence of migraine was 60.7% in patients with BrS/DItype 1 BrP and 30.3% in control group (p = 3.6 × 10 −14). On stepwise regression analysis, familial migraine (odds ratio [OR] of 4.4; 95% confidence interval [CI]: 2.0-9.8; p = 1.3 × 10 −4), vestibular migraine (OR of 5.4; 95% CI: 1.4-21.0); p = .013), migraine with visual aura (OR of 1.8; 95% CI: 1.0-3.4); p = .04) and younger age-atonset of migraine (OR of 0.95; 95% CI: 0.93-0.98); p = .004) were predictors of underlying BrS/DI-type 1 BrP among migraineurs. Use of anti-migraine drugs classified as "to be avoided" or "preferably avoided" in patients with BrS and several other anti-migraine drugs with potential cardiac I Na /I Ca channel blocking properties was present in 25.6% and 26.9% of migraineurs with BrS/DI-type 1 BrP, respectively. Conclusion: Migraine comorbidity is common in patients with BrS/DI-type 1 BrP. We identify several clinical variables that point to an underlying type-1 BrP among migraineurs, necessitating cautious use of certain anti-migraine drugs.

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Assessment of atrial functional remodeling in patients with atrioventricular nodal reentrant tachycardia with and without drug‐induced type 1 Brugada pattern: A case‐control study

Kocabaş

Payzın

Hasdemir

2021

J of Clinical Ultrasound

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Purpose The time interval between the onset of the P‐wave on electrocardiogram (ECG) and peak A′ velocity of the lateral left atrial wall assessed by tissue Doppler imaging (PA‐TDI interval) determine total atrial conduction time (TACT) which reflects atrial remodeling and arrhythmic substrate. In this retrospective study, we aimed to assess TACT in patients with atrioventricular nodal reentrant tachycardia (AVNRT) with and without drug‐induced type 1 Brugada electrocardiogram ECG pattern (DI‐Type 1 BrP) and control subjects. Methods Study population consisted of 62 consecutive patients (46 women; mean age 44 ± 12 years) undergoing electrophysiological study and ablation for symptomatic, drug‐resistant AVNRT, and 42 age‐matched and sex‐matched control subjects. All patients and control subjects underwent ajmaline challenge test and tissue Doppler imaging. Results A DI‐Type 1 BrP was uncovered in 24 of 62 patients with AVNRT (38.7%). PA‐TDI interval was similar among AVNRT patients with and without DI‐Type 1 BrP (124 ± 12 ms vs 119 ± 14 ms, respectively, P = .32), but significantly longer in patients with AVNRT with as well as without DI‐Type 1 BrP than in control subjects (124 ± 12 ms and 119 ± 14 ms vs 105 ± 11 ms, respectively, P < .001). Conclusion The TACT assessed by PA‐TDI interval is longer in patients with AVNRT with and without DI‐Type 1 BrP than in age‐matched and sex‐matched healthy control subjects.

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Coexistence of atrioventricular accessory pathways and drug‐induced type 1 Brugada pattern

Abstract: DI-Type1-BrP is relatively common in patients with AV-APs. We identify 12-lead ECG characteristics during preexcitation and orthodromic AVRT that point to an underlying type1-BrP, portending an increased probability for development of malignant arrhythmias.

Cited by 14 publications

References 35 publications

2020 APHRS/HRS expert consensus statement on the investigation of decedents with sudden unexplained death and patients with sudden cardiac arrest, and of their families

2020 APHRS/HRS expert consensus statement on the investigation of decedents with sudden unexplained death and patients with sudden cardiac arrest, and of their families

Recognition and clinical implications of high prevalence of migraine in patients with Brugada syndrome and drug‐induced type 1 Brugada pattern

Assessment of atrial functional remodeling in patients with atrioventricular nodal reentrant tachycardia with and without drug‐induced type 1 Brugada pattern: A case‐control study

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