Diagnostic utility of bipolar precordial leads during ajmaline testing for suspected Brugada syndrome

Heart Rhythm : the Official Journal of the Heart Rhythm Society
Velislav N BatchvarovElijah R Behr

Abstract

Leads V(1) and V(2) recorded from the standard position (fourth intercostal space) have insufficient sensitivity to detect the diagnostic type 1 Brugada ECG pattern. The purpose of this study was to compare the sensitivity of bipolar leads with a positive pole at V(2) and a negative pole at V(4) or V(5) with that of the standard unipolar lead V(2) for detection of the type 1 Brugada pattern. We analyzed digital 15-lead ECGs (12 standard leads plus leads V(1) to V(3) recorded from the third intercostal space [V(1h) to V(3h)]) acquired during diagnostic ajmaline testing in 128 patients (80 men, age 37 +/- 15 years) with suspected Brugada syndrome and standard 12-lead ECGs recorded in 229 healthy subjects (111 men, age 33 +/- 4 years). Bipolar leads between V(2) (positive pole) and V(4) or V(5) (leads V(2-4), V(2-5)) were derived by subtracting leads V(4) and V(5) from V(2). All ECGs were examined for the presence of type 1 Brugada pattern. During 21 (16.4%) positive ajmaline tests, type 1 pattern was observed in lead V(2h) during 20 tests (95.2%) and in V(2) during 10 tests (47.6%). Type 1 pattern appeared in lead V(2-4) or V(2-5) in all tests when it was present in V(2) and in seven tests during which it was observed in lead V(2...Continue Reading

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Citations

Jul 26, 2011·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Peter OngElijah R Behr
May 6, 2014·Journal of Electrocardiology·Velislav N Batchvarov, Elijah R Behr
Feb 18, 2011·Expert Opinion on Pharmacotherapy·Alessandro Marinelli, Alessandro Capucci
Mar 19, 2013·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Velislav N BatchvarovElijah R Behr
Jun 15, 2010·Journal of Electrocardiology·Velislav N Batchvarov, Elijah R Behr
Dec 17, 2009·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Wataru Shimizu
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Apr 15, 2015·Journal of the Saudi Heart Association·Abdulrahman NaseefVelislav N Batchvarov
Dec 30, 2014·Journal of Electrocardiology·Velislav N Batchvarov, Elijah R Behr
Jun 29, 2011·Circulation·Simon Modi, Andrew D Krahn

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