Can specific ECG markers identify a pharmacologically induced type 1 Brugada pattern? Insights from a large, single-center cohort. in Journal of electrocardiology / J Electrocardiol. 2023 Sep 2;81:123-131. doi: 10.1016/j.jelectrocard.2023.08.017.
2023
ASL Vercelli
Tipo pubblicazione
Journal Article
Autori/Collaboratori (8)Vedi tutti...
Occhetta E
Cardiology Division, Ospedale S. Andrea, Vercelli, Italy. Electronic address: eraldo864@gmail.com.
De Vecchi F
Cardiology Division, Ospedale S. Andrea, Vercelli, Italy; University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy.
Barbonaglia L
Cardiology Division, Ospedale S. Andrea, Vercelli, Italy.
et alii...
Abstract
BACKGROUND: In patients with a type 2 or 3 Brugada pattern, the pharmacological (IC drugs) induction of a type 1 pattern confirms the diagnosis of Brugada syndrome. OBJECTIVE: To evaluate the value of various ECG markers in predicting IC drug test results. METHODS: We retrospectively analysed 443 consecutive patients referred to our Center (from January 2010 to December 2019) to undergo Ajmaline/Flecainide testing; all had a type 2 or 3 Brugada pattern or were relatives with Brugada syndrome. Clinical parameters and ECG markers (r(1)V(1) and SV(6) duration and amplitude, QRSV(1)/QRSV(6) duration, V(1) and V(2) ST amplitude) were independently evaluated for their association to pharmacological test positivity, and a logistic regression model was applied. RESULTS: The drug test was positive in 151 (34%) patients. On multivariate logistic regression analysis, age > 45 years, female gender, HR >60 bpm, QRSV(1)/QRSV(6) duration >1 and non-isoelectric pattern in V(2) were associated with a positive test. The percentage of patients who tested positive increased according to the presence of the above ECG markers (from 11.3% in the absence to 57.6% in the presence of both factors). During long-term follow-up, the clinical event rate was higher in patients with predictive ECG markers and very low in those without. CONCLUSIONS: In our population we confirmed the ability of QRSV(1)/QRSV(6) duration >1 and of a non-isoelectric pattern in V(2) to predict a pharmacologically induced type 1 Brugada pattern. Patients with neither of these ECG markers had a rather low event rate during follow-up.
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PMID : 37688842
DOI : 10.1016/j.jelectrocard.2023.08.017
Keywords
Genetic arrhythmogenic disease; Flecainide; ECG predictive markers; Brugada syndrome; Ajmaline;