Epicardial electrogram of the right ventricular outflow tract in patients with the Brugada syndrome

Using the epicardial lead

Satoshi Nagase, Kengo Fukushima Kusano, Hiroshi Morita, Yoshihisa Fujimoto, Mikio Kakishita, Kazufumi Nakamura, Tetsuro Emori, Hiromi Matsubara, Tohru Ohe

Research output: Contribution to journalArticle

158 Citations (Scopus)

Abstract

OBJECTIVES: We tried to record an epicardial electrogram directly, and we examined local electrograms before and after administration of a class IC anti-arrhythmic drug in patients with the Brugada syndrome. BACKGROUND: Electrical heterogeneity of the epicardium in the right ventricular outflow tract (RVOT) has been thought to be related to the Brugada syndrome. However, an epicardial abnormality has not been demonstrated in patients with the Brugada syndrome. METHODS: In five patients with a Brugada-type electrocardiogram (ECG), local unipolar electrograms were recorded at the epicardium and endocardium of the RVOT. To record the epicardial electrogram directly, we introduced an electrical guidewire into the conus branch (CB) of the right coronary artery. The duration of the local electrogram after termination of the QRS complex (DP) was measured before and after class IC anti-arrhythmic drug administration. The signal-averaged electrocardiogram (SAECG) was also obtained in all patients. RESULTS: A definite DP was observed at the epicardium, but not at the endocardium. After administration of a class IC anti-arrhythmic drug, the DP at the epicardium was prolonged from 38 ± 10 ms to 67 ± 24 ms. The late potential corresponding to the DP at the epicardium was observed in all patients on the SAECG. CONCLUSIONS: An epicardial electrogram can be recorded from the CB. Recording from the CB enables identification of an epicardial abnormality in patients with the Brugada syndrome. These abnormal electrograms may be related to a myocardial abnormality in the epicardium of patients with the Brugada syndrome.

Original languageEnglish
Pages (from-to)1992-1995
Number of pages4
JournalJournal of the American College of Cardiology
Volume39
Issue number12
DOIs
Publication statusPublished - Jun 19 2002

Fingerprint

Brugada Syndrome
Pericardium
Anti-Arrhythmia Agents
Endocardium
Electrocardiography
Pharmaceutical Preparations
Lead
Coronary Vessels

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Epicardial electrogram of the right ventricular outflow tract in patients with the Brugada syndrome : Using the epicardial lead. / Nagase, Satoshi; Kusano, Kengo Fukushima; Morita, Hiroshi; Fujimoto, Yoshihisa; Kakishita, Mikio; Nakamura, Kazufumi; Emori, Tetsuro; Matsubara, Hiromi; Ohe, Tohru.

In: Journal of the American College of Cardiology, Vol. 39, No. 12, 19.06.2002, p. 1992-1995.

Research output: Contribution to journalArticle

Nagase, Satoshi ; Kusano, Kengo Fukushima ; Morita, Hiroshi ; Fujimoto, Yoshihisa ; Kakishita, Mikio ; Nakamura, Kazufumi ; Emori, Tetsuro ; Matsubara, Hiromi ; Ohe, Tohru. / Epicardial electrogram of the right ventricular outflow tract in patients with the Brugada syndrome : Using the epicardial lead. In: Journal of the American College of Cardiology. 2002 ; Vol. 39, No. 12. pp. 1992-1995.
@article{0a0801d641f94f0f98a113a659830794,
title = "Epicardial electrogram of the right ventricular outflow tract in patients with the Brugada syndrome: Using the epicardial lead",
abstract = "OBJECTIVES: We tried to record an epicardial electrogram directly, and we examined local electrograms before and after administration of a class IC anti-arrhythmic drug in patients with the Brugada syndrome. BACKGROUND: Electrical heterogeneity of the epicardium in the right ventricular outflow tract (RVOT) has been thought to be related to the Brugada syndrome. However, an epicardial abnormality has not been demonstrated in patients with the Brugada syndrome. METHODS: In five patients with a Brugada-type electrocardiogram (ECG), local unipolar electrograms were recorded at the epicardium and endocardium of the RVOT. To record the epicardial electrogram directly, we introduced an electrical guidewire into the conus branch (CB) of the right coronary artery. The duration of the local electrogram after termination of the QRS complex (DP) was measured before and after class IC anti-arrhythmic drug administration. The signal-averaged electrocardiogram (SAECG) was also obtained in all patients. RESULTS: A definite DP was observed at the epicardium, but not at the endocardium. After administration of a class IC anti-arrhythmic drug, the DP at the epicardium was prolonged from 38 ± 10 ms to 67 ± 24 ms. The late potential corresponding to the DP at the epicardium was observed in all patients on the SAECG. CONCLUSIONS: An epicardial electrogram can be recorded from the CB. Recording from the CB enables identification of an epicardial abnormality in patients with the Brugada syndrome. These abnormal electrograms may be related to a myocardial abnormality in the epicardium of patients with the Brugada syndrome.",
author = "Satoshi Nagase and Kusano, {Kengo Fukushima} and Hiroshi Morita and Yoshihisa Fujimoto and Mikio Kakishita and Kazufumi Nakamura and Tetsuro Emori and Hiromi Matsubara and Tohru Ohe",
year = "2002",
month = "6",
day = "19",
doi = "10.1016/S0735-1097(02)01888-0",
language = "English",
volume = "39",
pages = "1992--1995",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "12",

}

TY - JOUR

T1 - Epicardial electrogram of the right ventricular outflow tract in patients with the Brugada syndrome

T2 - Using the epicardial lead

AU - Nagase, Satoshi

AU - Kusano, Kengo Fukushima

AU - Morita, Hiroshi

AU - Fujimoto, Yoshihisa

AU - Kakishita, Mikio

AU - Nakamura, Kazufumi

AU - Emori, Tetsuro

AU - Matsubara, Hiromi

AU - Ohe, Tohru

PY - 2002/6/19

Y1 - 2002/6/19

N2 - OBJECTIVES: We tried to record an epicardial electrogram directly, and we examined local electrograms before and after administration of a class IC anti-arrhythmic drug in patients with the Brugada syndrome. BACKGROUND: Electrical heterogeneity of the epicardium in the right ventricular outflow tract (RVOT) has been thought to be related to the Brugada syndrome. However, an epicardial abnormality has not been demonstrated in patients with the Brugada syndrome. METHODS: In five patients with a Brugada-type electrocardiogram (ECG), local unipolar electrograms were recorded at the epicardium and endocardium of the RVOT. To record the epicardial electrogram directly, we introduced an electrical guidewire into the conus branch (CB) of the right coronary artery. The duration of the local electrogram after termination of the QRS complex (DP) was measured before and after class IC anti-arrhythmic drug administration. The signal-averaged electrocardiogram (SAECG) was also obtained in all patients. RESULTS: A definite DP was observed at the epicardium, but not at the endocardium. After administration of a class IC anti-arrhythmic drug, the DP at the epicardium was prolonged from 38 ± 10 ms to 67 ± 24 ms. The late potential corresponding to the DP at the epicardium was observed in all patients on the SAECG. CONCLUSIONS: An epicardial electrogram can be recorded from the CB. Recording from the CB enables identification of an epicardial abnormality in patients with the Brugada syndrome. These abnormal electrograms may be related to a myocardial abnormality in the epicardium of patients with the Brugada syndrome.

AB - OBJECTIVES: We tried to record an epicardial electrogram directly, and we examined local electrograms before and after administration of a class IC anti-arrhythmic drug in patients with the Brugada syndrome. BACKGROUND: Electrical heterogeneity of the epicardium in the right ventricular outflow tract (RVOT) has been thought to be related to the Brugada syndrome. However, an epicardial abnormality has not been demonstrated in patients with the Brugada syndrome. METHODS: In five patients with a Brugada-type electrocardiogram (ECG), local unipolar electrograms were recorded at the epicardium and endocardium of the RVOT. To record the epicardial electrogram directly, we introduced an electrical guidewire into the conus branch (CB) of the right coronary artery. The duration of the local electrogram after termination of the QRS complex (DP) was measured before and after class IC anti-arrhythmic drug administration. The signal-averaged electrocardiogram (SAECG) was also obtained in all patients. RESULTS: A definite DP was observed at the epicardium, but not at the endocardium. After administration of a class IC anti-arrhythmic drug, the DP at the epicardium was prolonged from 38 ± 10 ms to 67 ± 24 ms. The late potential corresponding to the DP at the epicardium was observed in all patients on the SAECG. CONCLUSIONS: An epicardial electrogram can be recorded from the CB. Recording from the CB enables identification of an epicardial abnormality in patients with the Brugada syndrome. These abnormal electrograms may be related to a myocardial abnormality in the epicardium of patients with the Brugada syndrome.

UR - http://www.scopus.com/inward/record.url?scp=0037134843&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037134843&partnerID=8YFLogxK

U2 - 10.1016/S0735-1097(02)01888-0

DO - 10.1016/S0735-1097(02)01888-0

M3 - Article

VL - 39

SP - 1992

EP - 1995

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 12

ER -