Risk stratification for asymptomatic patients with Brugada syndrome - Prediction of induction of ventricular fibrillation by noninvasive methods

Hiroshi Morita, Shiho Takenaka-Morita, Kengo Fukushima-Kusano, Makoto Kobayashi, Satoshi Nagase, Mikio Kakishita, Kazufumi Nakamura, Tetsuro Emori, Hiromi Matsubara, Tohru Ohe

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60 Citations (Scopus)

Abstract

Ventricular fibrillation (VF) is induced in some asymptomatic patients with Brugada syndrome (BS), but the prognostic value of programmed electrical stimulation (PES) in such patients is controversial. The clinical characteristics of 41 asymptomatic BS patients, divided into 2 groups according to whether VF was induced by PES (inducible VF group: n=13, non-inducible VF group: n=28) were evaluated. ST levels in the right precordial leads were measured before and after administration of pilsicainide and the abnormal late potential (LP) was evaluated on the signal-averaged electrogram. The ST level at V2 at baseline in the inducible VF group was significantly higher than that in the non-inducible VF group (p<0.05). Pilsicainide induced significant ST segment elevation in both groups and the ST level after pilsicainide in the inducible VF group was higher than that in the non-inducible VF group (p<0.01). LP was more frequent in the inducible VF group than in the non-inducible VF group. The criterion of ST level >0.15 mV at baseline with pilsicainide-induced additional ST elevation >0.10 mV and positive LP showed high sensitivity (92%) and specificity (89%) for detection of PES-induced VF in asymptomatic BS patients.

Original languageEnglish
Pages (from-to)312-316
Number of pages5
JournalCirculation Journal
Volume67
Issue number4
DOIs
Publication statusPublished - Apr 1 2003

Keywords

  • Brugada syndrome
  • Pilsicainide
  • Programmed electrical stimulation
  • Signal average electrogram
  • Ventricular fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Morita, H., Takenaka-Morita, S., Fukushima-Kusano, K., Kobayashi, M., Nagase, S., Kakishita, M., Nakamura, K., Emori, T., Matsubara, H., & Ohe, T. (2003). Risk stratification for asymptomatic patients with Brugada syndrome - Prediction of induction of ventricular fibrillation by noninvasive methods. Circulation Journal, 67(4), 312-316. https://doi.org/10.1253/circj.67.312