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ID 53013
FullText URL
Author
Tokioka, Koji
Kusano, Kengo F.
Miura, Daiji
Nishii, Nobuhiro
Nagase, Satoshi
Kohno, Kunihisa
Ohe, Tohru
Abstract
Objectives This study aimed to determine the usefulness of the combination of several electrocardiographic markers on risk assessment of ventricular fibrillation (VF) in patients with Brugada syndrome (BrS). Background Detection of high-/low-risk BrS patients using a noninvasive method is an important issue in the clinical setting. Several electrocardiographic markers related to depolarization and repolarization abnormalities have been reported, but the relationship and usefulness of these parameters in VF events are unclear. Methods Baseline characteristics of 246 consecutive patients (236 men; mean age, 47.6 +/- 13.6 years) with a Brugada-type electrocardiogram, including 13 patients with a history of VF and 40 patients with a history of syncope episodes, were retrospectively analyzed. During the mean follow-up period of 45.1 months, VF in 23 patients and sudden cardiac death (SCD) in 1 patient were observed. Clinical/ genetic and electrocardiographic parameters were compared with VF/SCD events. Results On univariate analysis, a history of VF and syncope episodes, paroxysmal atrial fibrillation, spontaneous type 1 pattern in the precordial leads, and electrocardiographic markers of depolarization abnormalities (QRS duration >= 120 ms, and fragmented QRS [f-QRS]) and those of repolarization abnormalities (inferolateral early repolarization [ER] pattern and QT prolongation) were associated with later cardiac events. On multivariable analysis, a history of VF and syncope episodes, inferolateral ER pattern, and f-QRS were independent predictors of documented VF and SCD (odds ratios: 19.61, 28.57, 2.87, and 5.21, respectively; p < 0.05). Kaplan-Meier curves showed that the presence/ absence of inferolateral ER and f-QRS predicted a worse/better prognosis (log-rank test, p < 0.01). Conclusions The combination of depolarization and repolarization abnormalities in BrS is associated with later VF events. The combination of these abnormalities is useful for detecting high-and low-risk BrS patients.
Keywords
Brugada syndrome
early repolarization
fragmented QRS
noninvasive risk assessment
ventricular fibrillation
Published Date
2014-05-27
Publication Title
Journal of the American College of Cardiology
Volume
volume63
Issue
issue20
Start Page
2131
End Page
2138
ISSN
0735-1097
Content Type
Journal Article
Related Url
http://ousar.lib.okayama-u.ac.jp/metadata/52969
language
英語
Copyright Holders
(c) 2014 by the American College of Cardiology Foundation
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author
Refereed
True
DOI
Web of Sience KeyUT