Abnormal restitution property of action potential duration and conduction delay in Brugada syndrome: Both repolarization and depolarization abnormalities

Nobuhiro Nishii, Satoshi Nagase, Hiroshi Morita, Kengo Fukushima Kusano, Tsunetoyo Namba, Daiji Miura, Kohei Miyaji, Shigeki Hiramatsu, Takeshi Tada, Masato Murakami, Atsuyuki Watanabe, Kimikazu Banba, Yoshiaki Sakai, Kazufumi Nakamura, Takefumi Oka, Tohru Ohe

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20 Citations (Scopus)

Abstract

Aims This study sought to examine the action potential duration restitution (APDR) property and conduction delay in Brugada syndrome (BrS) patients. A steeply sloped APDR curve and conduction delay are known to be important determinants for the occurrence of ventricular fibrillation (VF).Methods and resultsEndocardial monophasic action potential was obtained from 39 BrS patients and 9 control subjects using the contact electrode method. Maximum slopes of the APDR curve were obtained at both the right ventricular outflow tract (RVOT) and the right ventricular apex (RVA). The onset of activation delay (OAD) after premature stimulation was examined as a marker of conduction delay. Maximum slope of the APDR curve in BrS patients was significantly steeper than that in control subjects at both the RVOT and the RVA (0.77 ± 0.21 vs. 058 ± 0.14 at RVOT, P = 0.009; 0.98 ± 0.23 vs. 0.62 ± 0.16 at RVA, P = 0.001). The dispersion of maximum slope of the APDR curve between the RVOT and the RVA was also larger in BrS patients than in control subjects. The OAD was significantly longer in BrS patients than in control subjects from the RVOT to RVA and from the RVA to RVOT (from RVOT to RVA: 256 ± 12 vs. 243 ± 7 ms, P = 0.003; from RVA to RVOT: 252 ± 11 vs. 241 ± 9 ms, P = 0.01).ConclusionsAbnormal APDR properties and conduction delay were observed in BrS patients. Both repolarization and depolarization abnormalities are thought to be related to the development of VF in BrS patients.

Original languageEnglish
Pages (from-to)544-552
Number of pages9
JournalEuropace
Volume12
Issue number4
DOIs
Publication statusPublished - Apr 1 2010

Keywords

  • Brugada syndrome
  • Conduction delay
  • Monophasic action potential duration
  • Restitution curve
  • Ventricular fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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    Nishii, N., Nagase, S., Morita, H., Kusano, K. F., Namba, T., Miura, D., Miyaji, K., Hiramatsu, S., Tada, T., Murakami, M., Watanabe, A., Banba, K., Sakai, Y., Nakamura, K., Oka, T., & Ohe, T. (2010). Abnormal restitution property of action potential duration and conduction delay in Brugada syndrome: Both repolarization and depolarization abnormalities. Europace, 12(4), 544-552. https://doi.org/10.1093/europace/eup432