학술논문

Progressive increase in activation delay during premature stimulation is related to ventricular fibrillation in Brugada syndrome.
Document Type
Article
Source
Journal of Cardiovascular Electrophysiology. Jul2021, Vol. 32 Issue 7, p1939-1946. 8p. 5 Charts, 3 Graphs.
Subject
*BRUGADA syndrome
*IMPLANTABLE cardioverter-defibrillators
*ELECTRIC stimulation
*DESCRIPTIVE statistics
*VENTRICULAR fibrillation
Language
ISSN
1045-3873
Abstract
Introduction: The local conduction delay has been deemed to play an important role in the perpetuation of ventricular fibrillation (VF) in Brugada syndrome (BrS). We evaluated the relationship between the activation delay during programmed stimulation and cardiac events in BrS patients. Methods: This study included 47 consecutive BrS patients who underwent an electrophysiological study and received implantable cardiac defibrillator therapy. We divided the patients into two groups based on whether they had developed VF (11 patients) or not (36 patients) during the follow‐up period of 89 ± 53 months. The activation delay was assessed using the interval between the stimulus and the QRS onset during programmed stimulation. The mean increase in delay (MID) was used to characterize the conduction curves. Results: The MID at the right ventricular outflow tract (RVOT) was significantly greater in patients with VF (4.5 ± 1.2 ms) than in those without VF (2.2 ± 0.9 ms) (p <.001). A receiver operating characteristics curve analysis indicated that the optimal cut‐off point for discriminating VF occurrence was 3.3 with 88.9% sensitivity and 91.3% specificity. Furthermore, patients with an MID at the RVOT ≥ 3.3 ms showed significantly higher rates of VF recurrence than those with an MID at the RVOT < 3.3 ms (p <.001). The clinical characteristics, including the signal‐averaged electrocardiogram measurement and VF inducibility were similar between the two groups. Conclusion: A prolonged MID at the RVOT was associated with VF and maybe an additional electrophysiological risk factor for VF in BrS patients. [ABSTRACT FROM AUTHOR]