INTRODUCTION: Risk stratification for life-threatening arrhythmic events in Brugada syndrome is not yet established. The aim of the present study was to examine the usefulness of various markers in predicting life-threatening arrhythmic events in the Brugada syndrome. METHODS AND RESULTS: Forty-six patients with Brugada-type ECGs were categorized into the symptomatic (n=28) and asymptomatic (n=18) groups. Statistical analyses were performed with respect to the usefulness of the following markers: SCN5A mutation, pharmacologic challenge, ventricular fibrillation (VF) inducibility by programmed electrical stimulation, and late potential (LP) by signal-averaged ECG (SAECG). Comparison between the two groups revealed a significant difference only in LP positivity (92.6% vs 47.1%, P=0.0004). The symptomatic group had significantly lower RMS40, longer LAS40, and longer fQRSd compared with the asymptomatic group. A significant difference was noted, especially RMS40. The positive predictive value, negative predictive value, and predictive accuracy when setting a cutoff value of 15 microV were 92.0%, 78.9%, and 86.4%, respectively. Furthermore, patients with an RMS40 value <15 microV (n=25) showed significantly higher rates of VF recurrence compared with patients with an RMS40 value > or = 15 microV (n=19, P=0.047). CONCLUSION: Regarding risk stratification for identifying high-risk patients in Brugada syndrome, only LP by SAECG was shown to be useful, suggesting the importance of RMS40 in predicting the history of life-threatening arrhythmic events and the recurrence of VF.
INTRODUCTION: Risk stratification for life-threatening arrhythmic events in Brugada syndrome is not yet established. The aim of the present study was to examine the usefulness of various markers in predicting life-threatening arrhythmic events in the Brugada syndrome. METHODS AND RESULTS: Forty-six patients with Brugada-type ECGs were categorized into the symptomatic (n=28) and asymptomatic (n=18) groups. Statistical analyses were performed with respect to the usefulness of the following markers: SCN5A mutation, pharmacologic challenge, ventricular fibrillation (VF) inducibility by programmed electrical stimulation, and late potential (LP) by signal-averaged ECG (SAECG). Comparison between the two groups revealed a significant difference only in LP positivity (92.6% vs 47.1%, P=0.0004). The symptomatic group had significantly lower RMS40, longer LAS40, and longer fQRSd compared with the asymptomatic group. A significant difference was noted, especially RMS40. The positive predictive value, negative predictive value, and predictive accuracy when setting a cutoff value of 15 microV were 92.0%, 78.9%, and 86.4%, respectively. Furthermore, patients with an RMS40 value <15 microV (n=25) showed significantly higher rates of VF recurrence compared with patients with an RMS40 value > or = 15 microV (n=19, P=0.047). CONCLUSION: Regarding risk stratification for identifying high-risk patients in Brugada syndrome, only LP by SAECG was shown to be useful, suggesting the importance of RMS40 in predicting the history of life-threatening arrhythmic events and the recurrence of VF.
Authors: Man Liu; Shamarendra Sanyal; Ge Gao; Iman S Gurung; Xiaodong Zhu; Georgia Gaconnet; Laurie J Kerchner; Lijuan L Shang; Christopher L-H Huang; Andrew Grace; Barry London; Samuel C Dudley Journal: Circ Res Date: 2009-09-10 Impact factor: 17.367
Authors: A Corrias; X Jie; L Romero; M J Bishop; M Bernabeu; E Pueyo; B Rodriguez Journal: Philos Trans A Math Phys Eng Sci Date: 2010-06-28 Impact factor: 4.226