Day-to-Day Variation of Early Repolarization Pattern Predicts Life-Threatening Arrhythmias in Patients With Brugada Syndrome
Open Access
- 25 February 2021
- journal article
- research article
- Published by Japanese Circulation Society in Circulation Journal
- Vol. 85 (3), 300-308
- https://doi.org/10.1253/circj.cj-20-0142
Abstract
Background:We assessed the relationship between day-to-day variation of the early repolarization (ER) pattern and ventricular tachyarrhythmia (VTA) events in Brugada syndrome (BrS) patients because the clinical implications are unclear. Methods and Results:This retrospective study consisted of 41 patients with BrS who underwent implantable cardioverter-defibrillator (ICD) implantation. BrS was diagnosed by a spontaneous or drug-induced type 1 ECG without structural heart disease. Day-to-day variation of the ER pattern was defined as temporal change in the J-point (≥0.1 mV) on ECG. VTA events were detected via ICD interrogation: 15 patients experienced VTA events during 124±62 months’ observation. Day-to-day variation of the ER pattern was positive in 7 patients (17%). In the multivariate Cox proportional hazards model, day-to-day variation of a positive ER pattern (hazard ratio [HR]: 3.475, 95% confidence interval [CI]: 1.105–10.414, P=0.034) and documented history of VTA (HR: 4.802, 95% CI: 1.547–17.995, P=0.006) were independent predictors of VTA events. In patients with electrical storm (ES: n=9), day-to-day variation of the ER pattern was positive in 5 patients (56%). ES events were more frequently observed in patients with a positive day-to-day variation of ER pattern than in those without (PConclusions:The incidence of day-to-day variation of the ER pattern was higher in patients with arrhythmic events of VTA and/or ES among BrS patients with ICD.Keywords
This publication has 29 references indexed in Scilit:
- Guidelines for Non-Pharmacotherapy of Cardiac Arrhythmias (JCS 2011)Circulation Journal, 2013
- J wave syndromesHeart Rhythm, 2010
- Long-Term Outcome Associated with Early Repolarization on ElectrocardiographyThe New England Journal of Medicine, 2009
- Long-Term Prognosis of Probands With Brugada-Pattern ST-Elevation in Leads V 1 –V 3Circulation: Arrhythmia and Electrophysiology, 2009
- Inferior and Lateral Electrocardiographic Repolarization Abnormalities in Brugada SyndromeCirculation: Arrhythmia and Electrophysiology, 2009
- Fragmented QRS as a Marker of Conduction Abnormality and a Predictor of Prognosis of Brugada SyndromeCirculation, 2008
- Augmentation of J Waves and Electrical Storms in Patients with Early RepolarizationThe New England Journal of Medicine, 2008
- Tpeak-Tend and Tpeak-Tend Dispersion as Risk Factors for Ventricular Tachycardia/Ventricular Fibrillation in Patients With the Brugada SyndromeJournal of the American College of Cardiology, 2006
- Brugada Syndrome: Report of the Second Consensus ConferenceCirculation, 2005
- Right bundle branch block, persistent ST segment elevation and sudden cardiac death: A distinct clinical and electrocardiographic syndrome: A multicenter reportJournal of the American College of Cardiology, 1992