Lena Rivard1, Antoine Roux2, Isabelle Nault2, Jean Champagne2, Jean-François Roux3, Rafik Tadros4, Mario Talajic4, Julia Cadrin-Tourigny4, Azadeh Shohoudi5, Blandine Mondésert4, Denis Roy4, Laurent Macle4, Jason Andrade4, Katia Dyrda4, Marc Dubuc4, Peter G Guerra4, Jean-François Sarrazin2, Bernard Thibault4, Paul Khairy6. 1. Department of Medicine, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada. Electronic address: lena.rivard@umontreal.ca. 2. Department of Medicine, Québec Heart and Lung Institute, Université Laval, Québec City, Québec, Canada. 3. Department of Medicine, Centre Hospitalier Université de Sherbrooke, Université de Sherbrooke, Sherbrooke, Québec, Canada. 4. Department of Medicine, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada. 5. Montréal Health Innovations Coordinating Center (MHICC), Montréal Heart Institute, Montréal, Québec, Canada. 6. Department of Medicine, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada; Montréal Health Innovations Coordinating Center (MHICC), Montréal Heart Institute, Montréal, Québec, Canada.
Abstract
BACKGROUND: Patients with Brugada syndrome (BrS) are at risk for ventricular arrhythmias (VAs) and sudden death. Identification of high-risk individuals beyond those with syncope or resuscitated sudden death remains a major challenge. METHODS: We assessed the value of clinical, electrophysiological, and electrocardiographic (ECG) features, including depolarization and repolarization metrics, in predicting arrhythmic events and sudden death in consecutive patients with BrS diagnosed between 2002 and 2013 in Quebec, Canada. Qualifying electrocardiograms with the highest type 1 ST-segment elevations were reviewed and analyzed by 2 electrophysiologists who were blinded to clinical history. Survival analyses were adjusted for Firth bias correction and left truncation. RESULTS: A total of 105 patients, 79.8% of whom were men, were diagnosed with BrS at a mean age of 46.2 ± 13.3 years and were followed for 59.6 ± 16.4 months. Ten (9.5%) had a history of cardiac arrest, 37 (35.2%) had syncope, and 7 (6.7%) experienced 20 arrhythmic events during follow-up, all consisting of appropriate ICD therapy (7 antitachycardia pacing; 13 shocks). In multivariate Cox regression analyses, a spontaneous type 1 electrocardiographic (ECG) pattern (hazard ratio [HR], 10.80; 95% confidence interval [CI], 1.03-113.87; P = 0.0476), maximal T peak-end (Tp-e) duration ≥ 100 ms (HR, 29.73; 95% CI, 1.33-666.37; P = 0.0325), and QRS duration in lead V6 > 110 ms (HR, 15.27; 95% CI, 1.07-217.42; P = 0.0443) were independently associated with VAs or aborted sudden cardiac death. CONCLUSIONS: In a multicentre cohort with BrS from Quebec, Canada, VAs and sudden death were independently associated with standard 12-lead ECG features, including a spontaneous type 1 pattern, depolarization (QRS in lead V6), and repolarization (maximal Tp-e duration) criteria.
BACKGROUND:Patients with Brugada syndrome (BrS) are at risk for ventricular arrhythmias (VAs) and sudden death. Identification of high-risk individuals beyond those with syncope or resuscitated sudden death remains a major challenge. METHODS: We assessed the value of clinical, electrophysiological, and electrocardiographic (ECG) features, including depolarization and repolarization metrics, in predicting arrhythmic events and sudden death in consecutive patients with BrS diagnosed between 2002 and 2013 in Quebec, Canada. Qualifying electrocardiograms with the highest type 1 ST-segment elevations were reviewed and analyzed by 2 electrophysiologists who were blinded to clinical history. Survival analyses were adjusted for Firth bias correction and left truncation. RESULTS: A total of 105 patients, 79.8% of whom were men, were diagnosed with BrS at a mean age of 46.2 ± 13.3 years and were followed for 59.6 ± 16.4 months. Ten (9.5%) had a history of cardiac arrest, 37 (35.2%) had syncope, and 7 (6.7%) experienced 20 arrhythmic events during follow-up, all consisting of appropriate ICD therapy (7 antitachycardia pacing; 13 shocks). In multivariate Cox regression analyses, a spontaneous type 1 electrocardiographic (ECG) pattern (hazard ratio [HR], 10.80; 95% confidence interval [CI], 1.03-113.87; P = 0.0476), maximal T peak-end (Tp-e) duration ≥ 100 ms (HR, 29.73; 95% CI, 1.33-666.37; P = 0.0325), and QRS duration in lead V6 > 110 ms (HR, 15.27; 95% CI, 1.07-217.42; P = 0.0443) were independently associated with VAs or aborted sudden cardiac death. CONCLUSIONS: In a multicentre cohort with BrS from Quebec, Canada, VAs and sudden death were independently associated with standard 12-lead ECG features, including a spontaneous type 1 pattern, depolarization (QRS in lead V6), and repolarization (maximal Tp-e duration) criteria.
Authors: Ahmed Bayoumy; Meng-Qi Gong; Ka Hou Christien Li; Sunny Hei Wong; William Kk Wu; Guang-Ping Li; George Bazoukis; Konstantinos P Letsas; Wing Tak Wong; Yun-Long Xia; Tong Liu; Gary Tse Journal: J Geriatr Cardiol Date: 2017-10 Impact factor: 3.327
Authors: Lei Meng; Konstantinos P Letsas; Adrian Baranchuk; Qingmiao Shao; Gary Tse; Nixiao Zhang; Zhiwei Zhang; Dan Hu; Guangping Li; Tong Liu Journal: Front Physiol Date: 2017-09-12 Impact factor: 4.566
Authors: Gary Tse; Mengqi Gong; Christien Ka Hou Li; Keith Sai Kit Leung; Stamatis Georgopoulos; George Bazoukis; Konstantinos P Letsas; Abhishek C Sawant; Giacomo Mugnai; Martin C S Wong; Gan Xin Yan; Pedro Brugada; Gian-Battista Chierchia; Carlo de Asmundis; Adrian Baranchuk; Tong Liu Journal: J Arrhythm Date: 2018-09-10