Body Surface Distribution and Response to Drugs of ST Segment Elevation in Brugada Syndrome: Clinical Implication of Eighty‐Seven–Lead Body Surface Potential Mapping and Its Application to Twelve‐Lead Electrocardiograms
Why the study?
What is the body surface distribution of ST segment elevation in Brugada syndrome and how does it respond to isoproterenol and disopyramide?
Population
25 patients with Brugada syndrome and 40 control patients
Comparison
87-lead body surface potential mapping and… vs Control patients and baseline conditions
Design
Case-control
Authors
Discussion
Loading...
Member takes
Implication
ST elevation magnitude and drug responses distinguish Brugada cases; hypothesis-generating for higher intercostal lead placement and provocative testing.
Key Points
- To clarify body surface distribution and magnitude of ST segment elevation in Brugada syndrome and its relationship with 12-lead ECGs.
- Eighty-seven-lead body surface potential mapping and 12-lead ECGs recorded in 25 Brugada syndrome patients and 40 controls.
- ST segment amplitude (ST20) measured 20 msec after QRS; isopotential maps constructed.
- Interventions with isoproterenol and disopyramide to assess their effects on ST elevation.
- Maximum ST elevation (maxST20) was 0.37 +/- 0.13 mV in Brugada patients versus 0.12 +/- 0.04 mV in controls (P < 0.0005).
- Isoproterenol normalized maxST20 to 0.17 +/- 0.08 mV (P < 0.0005) and disopyramide increased maxST20 to 0.50 +/- 0.15 mV (P < 0.0005).
- Location of maximum ST elevation remained unchanged despite medication.
Structured PICO
What is the body surface distribution of ST segment elevation in Brugada syndrome and how does it respond to isoproterenol and disopyramide?
P
Population
25 patients with Brugada syndrome and 40 control patients
I
Intervention
87-lead body surface potential mapping and 12-lead ECGs, with drug challenge using isoproterenol (beta-adrenergic agonist) and disopyramide (Na+ channel blocker)
C
Comparator
Control patients (for baseline mapping) and baseline conditions (for drug challenge)
O
Outcome
Amplitude and distribution of the ST segment 20 msec after the end of QRS (ST20)surrogate
Recording leads V1-V3 on the second or third intercostal space improves detection of ST elevation in suspected Brugada syndrome, which is accentuated by sodium channel blockers and normalized by beta-adrenergic agonists.
Cite This Study
Shimizu et al. (2000) studied this question.