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Abstract:

Late Potential in Brugada Syndrome.

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

V were 92.0%, 78.9%, and 86.4%, respectively. Furthermore, patients with an RMS40 value <15

V (n = 25) showed significantly higher rates of VF recurrence compared with patients with an RMS40 value

V (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.

(J Cardiovasc Electrophysiol, Vol. 16, pp. 45-51, January 2005)

Keywords: Brugada syndrome; risk stratification; signal-averaged electrocardiography; late potential; RMS40

Document Type: Research article

DOI: 10.1046/j.1540-8167.2005.04313.x

Affiliations: 1: From The Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan

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Assessment of Markers for Identifying Patients at Risk for Life-Threatening Arrhythmic Events in Brugada Syndrome