Relationship Between Dominant Prolongation of the Filtered QRS Duration in the Right Precordial Leads and Clinical Characteristics in Brugada Syndrome

Abstract

The dominant prolongation of the filtered QRS duration in the right precordial leads may be related to the risk of arrhythmic event in Brugada syndrome.

Diagnostic utility of bipolar precordial leads during ajmaline testing for suspected Brugada syndrome

“…The presence of late potentials and prolonged filtered QRS duration on signal-averaged ECG also have been linked to arrhythmic risk in Brugada syndrome. 26,27 Increased QRS fragmentation recently was shown to be related to the incidence of arrhythmic events in Brugada syndrome. 28 A mechanism explaining the Brugada ECG type solely by RVOT conduction delay has been proposed (see Figure 3 in Meregalli et al 29 ).…”

Significance of Early Onset and Progressive Increase of Activation Delay During Premature Stimulation in Brugada Syndrome

“…18 We previously reported that dominant prolongation of the filtered QRS duration in the right precordial leads was related to the risk of arrhythmic events in BS and that these parameters were not related to the conduction time from the RVOT to the RVA or to the HV interval. 4 We postulated that the prolongation of RfQRSd was a different parameter from conduction delay, including the HV interval, and we reported that the last part of the delayed potential with fQRSd in the right precordial leads was a low-frequency component compared with the LP in patients with ARVC. 5 Moreover, we reported a discrete LP in SAECG related to coved ST elevation, and this potential was induced by pilsicainide and abolished by quinidine when the ECG showed a coved-type ST elevation.…”

“…The standard precordial leads, V1-6, were amplified, digitized, and averaged (200-300 beats/min), and the fQRSd was measured. 4 The fQRSd in leads V2 and V5 was defined as the RfQRSd and LfQRSd, respectively. 4…”

“…[1][2][3] It is controversial whether repolarization or depolarization abnormalities play an important primary role in the occurrence of ventricular arrhythmia in BS. We previously reported that dominant prolongation of the filtered QRS duration (fQRSd) in the right precordial leads using signalaveraged ECG (SAECG) was related to the risk of arrhythmic events in BS, 4 and that the delayed potential with fQRSd in the right precordial leads was a low-frequency component compared with ARVC. 5 Moreover, we recently reported that in some patients with BS, a discrete potential in SAECG was related to coved ST elevation, and that the potential was induced by pilsicainide and abolished by quinidine.…”

Early repolarization and markers of ventricular arrhythmogenesis in patients referred to ambulatory 24-hour ECG recording

“…This may subsequently help in risk stratification of arrhythmic events in this group of people. Previous reports examined HRV [10][11][12][13] and ventricular LPs [14][15][16][17][18][19] in patients with Brugada syndrome (which is also an ECG phenotype characterized by elevated ST segment), but limited data exist on the association between early repolarization and these markers of arrhythmogenesis.…”