Spontaneous electrocardiogram alterations predict ventricular fibrillation in Brugada syndrome

Take, Yutaka; Morita, Hiroshi; Wu, Jiashin; Nagase, Satoshi; Morita, Shiho; Toh, Norihisa; Nishii, Nobuhiro; Nakamura, Kazufumi; Kusano, Kengo; Ohe, Tohru; Ito, Hiroshi; Zipes, Douglas P.

doi:10.1016/j.hrthm.2011.02.009

Cited by 34 publications

(25 citation statements)

References 29 publications

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“…Type I, II, and III Brugada patterns were defined according to standard criteria and as endorsed by the Consensus Document, 1 including recent important updates on the ECG diagnosis of Brugada syndrome 14 with the only exception that an ECG with a right bundle branch block pattern and classic coved-type ST-segment elevation was considered type I even in the absence of negative T waves in leads V 1 –V 3 . This is because when a coved ST segment-elevation is obvious , (1) the presence of inverted T waves is no longer considered a requisite for defining Brugada syndrome by most experts; (2) ECGs in a patient with typical coved type I pattern may or may not have a negative T wave on different days 15 ; and (3) the prognosis of coved-type ST-segment elevation without T-wave inversion is similar to that of the “classic” type I pattern. 15 …”

Section: Methodsmentioning

confidence: 99%

“…This is because when a coved ST segment-elevation is obvious , (1) the presence of inverted T waves is no longer considered a requisite for defining Brugada syndrome by most experts; (2) ECGs in a patient with typical coved type I pattern may or may not have a negative T wave on different days 15 ; and (3) the prognosis of coved-type ST-segment elevation without T-wave inversion is similar to that of the “classic” type I pattern. 15 …”

Section: Methodsmentioning

confidence: 99%

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Fever-induced Brugada pattern: How common is it and what does it mean?

Adler¹,

Topaz²,

Heller³

et al. 2013

Heart Rhythm

148

103

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BACKGROUND Fever is known to unmask the Brugada pattern on the electrocardiogram (ECG) and trigger ventricular arrhythmias in patients with Brugada syndrome. Genetic studies in selected cases with fever-induced Brugada pattern have identified disease-causing mutations. Thus, “fever-induced Brugada” is a recognized clinical entity. However, its prevalence has not been systematically evaluated. OBJECTIVE The purpose of this study was to assess the prevalence of Brugada pattern in consecutive patients with fever. METHODS ECGs of patients with fever admitted to the emergency department were evaluated for the presence of Brugada pattern and compared with ECGs of consecutive nonfebrile patients. RESULTS ECGs of 402 patients with fever and 909 without were evaluated. Type I Brugada pattern was 20 times more common in the febrile group than in the afebrile group (2% vs 0.1%, respectively, P = .0001). All patients with fever-induced type I Brugada pattern were asymptomatic and remained so during 30 months of follow-up. CONCLUSION Type I Brugada pattern is definitively more common among patients with fever, suggesting that asymptomatic Brugada syndrome is more prevalent than previously estimated.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Fever-induced Brugada pattern: How common is it and what does it mean?

Adler¹,

Topaz²,

Heller³

et al. 2013

Heart Rhythm

148

103

View full text Add to dashboard Cite

show abstract

“…113 A prospective study using signal-averaged ECG suggested that positive late potential may have predictive value of malignant arrhythmic events in BrS. 107 Of note, these studies were performed in a small number of patients and deserved further evaluation with a larger cohort.…”

Section: Insight Into Brugada Syndrome An Updatementioning

confidence: 99%

Brugada Syndrome

Mizusawa

Wilde

2012

Circ: Arrhythmia and Electrophysiology

253

254

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“…Fourth, the prevalence of Brugada syndrome in the present study might have been underestimated because Brugada-like ECG pattern changes over time. 30 Fifth, although 10 patients had early repolarization ECG pattern, of which the presence is indicated as a high risk for fatal VAs, 18 we were unable to elucidate its impact on the results of dual induction tests. Sixth, the small sample size of our subjects did not allow us to compare the long-term prognosis among groups classified by the dual induction test, with an appropriate correction for baseline differences.…”

Section: Study Limitationsmentioning

confidence: 89%

Usefulness of Testing for Coronary Artery Spasm and Programmed Ventricular Stimulation in Survivors of Out-of-Hospital Cardiac Arrest

Komatsu

Takahashi

Fukuda

et al. 2016

Circ: Arrhythmia and Electrophysiology

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Background-Optimal therapy for patients resuscitated from out-of-hospital cardiac arrest (OHCA) who are not found to have structural heart disease remains to be established, especially regarding the use of implantable cardioverterdefibrillators. Coronary artery spasm (CAS) and lethal ventricular arrhythmias are important causes of OHCA. Methods and Results-In 47 consecutive OHCA survivors without structural heart disease who had fully recovered (M/F 44/3, 43±13 years.), we performed dual induction tests, including acetylcholine provocation test first followed by programmed ventricular stimulation after 1 to 2 weeks. Patients with CAS were treated with calcium channel blockerbased antianginal medications; implantable cardioverter-defibrillators were implanted in all patients. The results of the dual induction tests defined 4 groups: CAS alone (n=7), inducible ventricular arrhythmias alone (n=13), both positive (n=24), and both negative (n=3). During a median follow-up period of 38 months, ventricular fibrillation recurred in all groups except the both-negative group. Of the 16 patients with a type I Brugada ECG, 2 had CAS alone, 8 had ventricular arrhythmias alone, and 6 had both positive. No ventricular fibrillation episodes were observed in the CAS-alone patients who did not also have Brugada syndrome. Kaplan-Meier analysis showed that the CAS-alone group was at lower risk for OHCA recurrence as compared with the Brugada syndrome group (log-rank test; P=0.036). Conclusions-Among OHCA survivors without structural heart disease, provokable CAS and ventricular arrhythmias are common and can be seen in Brugada syndrome. CAS alone without Brugada syndrome who are treated for CAS may be a lower-risk group. (Circ Arrhythm Electrophysiol. 2016;9:e003798.

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Spontaneous electrocardiogram alterations predict ventricular fibrillation in Brugada syndrome

Abstract: ECG alterations, especially conversion between types 0 and 1, are associated with significant AP heterogeneity that can initiate VF in BS.

Cited by 34 publications

References 29 publications

Fever-induced Brugada pattern: How common is it and what does it mean?

Fever-induced Brugada pattern: How common is it and what does it mean?

Brugada Syndrome

Usefulness of Testing for Coronary Artery Spasm and Programmed Ventricular Stimulation in Survivors of Out-of-Hospital Cardiac Arrest

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