Spatiotemporal Characteristics of QRS Complexes Enable the Diagnosis of Brugada Syndrome Regardless of the Appearance of a Type 1 ECG

Journal of Cardiovascular Electrophysiology
Maria S GuillemRamon Brugada

Abstract

The diagnosis of Brugada syndrome based on the ECG is hampered by the dynamic nature of its ECG manifestations. Brugada syndrome patients are only 25% likely to present a type 1 ECG. The objective of this study is to provide an ECG diagnostic criterion for Brugada syndrome patients that can be applied consistently even in the absence of a type 1 ECG. We recorded 67-lead body surface potential maps from 94 Brugada syndrome patients and 82 controls (including right bundle branch block patients and healthy individuals). The spatial propagation direction during the last r' wave and the slope at the end of the QRS complex were measured and compared between patients groups. Receiver-operating characteristic curves were constructed for half of the database to identify optimal cutoff values; sensitivity and specificity for these cutoff values were measured in the other half of the database. A spontaneous type 1 ECG was present in only 30% of BrS patients. An orientation in the sagittal plane < 101º during the last r' wave and a descending slope < 9.65 mV/s enables the diagnosis of the syndrome with a sensitivity of 69% and a specificity of 97% in non-type 1 Brugada syndrome patients. Spatiotemporal characteristics of surface ECG record...Continue Reading

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Citations

May 15, 2018·Expert Review of Cardiovascular Therapy·Mariana Argenziano, Charles Antzelevitch
Sep 9, 2017·Journal of Cardiovascular Electrophysiology·Koji NakagawaTohru Ohe
Jan 25, 2019·Journal of the American Heart Association·Allan Rivera-JuárezFelipe Atienza

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