BACKGROUND: Although arrhythmogenesis of Brugada syndrome is still unknown, it has been reported to be associated with conduction disturbances. Two ST-segment morphologies (coved and saddle-back patterns) have been described in this syndrome. No study has sought to determine which morphology has stronger conduction disturbances, thereby associating with life-threatening events. METHODS: Forty-six patients who presented the Brugada-type ECG with either of a characteristic coved (n = 25) or saddle-back (n = 21) pattern of ST-segment morphology underwent signal-averaged ECG (SAECG). SAECG parameters, and the history of life-threatening events defined as syncope or aborted sudden death, were compared between groups. RESULTS: Although filtered QRS duration did not differ between groups, the incidence of late potentials in the coved group was higher than in the saddle-back group (22 patients (88%) versus 4 patients (19%); P < 0.01), showing lower RMS40 and longer LAS40. Life-threatening events occurred in 17 patients (68%) in the coved group and 7 patients (33%) in the saddle-back group (P = 0.02). CONCLUSION: The coved pattern of ST segment was more closely related to conduction disturbances than the saddle-back pattern in patients with Brugada-type ECG. Life-threatening events were more common in patients with the coved ST-segment elevation. Conduction disturbances in the coved pattern of ST segment may reflect a substrate of arrhythmogenesis in Brugada syndrome.
BACKGROUND: Although arrhythmogenesis of Brugada syndrome is still unknown, it has been reported to be associated with conduction disturbances. Two ST-segment morphologies (coved and saddle-back patterns) have been described in this syndrome. No study has sought to determine which morphology has stronger conduction disturbances, thereby associating with life-threatening events. METHODS: Forty-six patients who presented the Brugada-type ECG with either of a characteristic coved (n = 25) or saddle-back (n = 21) pattern of ST-segment morphology underwent signal-averaged ECG (SAECG). SAECG parameters, and the history of life-threatening events defined as syncope or aborted sudden death, were compared between groups. RESULTS: Although filtered QRS duration did not differ between groups, the incidence of late potentials in the coved group was higher than in the saddle-back group (22 patients (88%) versus 4 patients (19%); P < 0.01), showing lower RMS40 and longer LAS40. Life-threatening events occurred in 17 patients (68%) in the coved group and 7 patients (33%) in the saddle-back group (P = 0.02). CONCLUSION: The coved pattern of ST segment was more closely related to conduction disturbances than the saddle-back pattern in patients with Brugada-type ECG. Life-threatening events were more common in patients with the coved ST-segment elevation. Conduction disturbances in the coved pattern of ST segment may reflect a substrate of arrhythmogenesis in Brugada syndrome.
Authors: T Ikeda; K Kumagai; M Takami; N Tezuka; T Nakae; T Sakata; M Noro; Y Enjoji; K Sugi; T Yamaguchi Journal: J Electrocardiol Date: 2000-07 Impact factor: 1.438
Authors: H Atarashi; S Ogawa; K Harumi; H Hayakawa; T Sugimoto; R Okada; M Murayama; J Toyama Journal: Am J Cardiol Date: 1996-09-01 Impact factor: 2.778
Authors: Q Chen; G E Kirsch; D Zhang; R Brugada; J Brugada; P Brugada; D Potenza; A Moya; M Borggrefe; G Breithardt; R Ortiz-Lopez; Z Wang; C Antzelevitch; R E O'Brien; E Schulze-Bahr; M T Keating; J A Towbin; Q Wang Journal: Nature Date: 1998-03-19 Impact factor: 49.962