October 31, 2025Heart Rhythm1 citationsOpen Access
New mechanistic observation: Ajmaline-induced epicardial “zigzag” electrogram pattern in Brugada syndrome
Key Result
Ajmaline-induced epicardial 'zigzag' electrogram patterns representing lines of conduction block were observed in Brugada syndrome, supporting slow conduction and conduction block mechanisms.
Study Design
Type
Case Report
Structured PICO
P
Population
Patients with Brugada syndrome
I
Intervention
Ajmaline administration and epicardial electrogram recording
O
Outcome
Observation of epicardial "zigzag" electrogram pattern and lines of conduction blocksurrogate
Provides new mechanistic insights into Brugada syndrome by describing an ajmaline-induced epicardial "zigzag" electrogram pattern indicative of conduction block.
Abstract
The discovery of epicardial late potentials in Brugada syndrome (BrS) has opened a lively debate on their pathophysiological significance.1,2 Most recent clinical and computer modeling studies have confirmed slow conduction and conduction block as mechanisms of ST elevation and ventricular fibrillation (VF) genesis in BrS.3, 4, 5 Nevertheless, electrogram (EGM) recordings of lines of conduction block (LOBs), which would be plausible in this scenario, have not been described.