Key result
Prior Brugada events associate with blunted peak heart rate and steeper recovery drops during exercise.
Why the study?
Prognostic stratification is needed in Brugada syndrome to identify candidates for implantable cardioverter defibrillators by evaluating electrocardiographic changes during exercise stress testing.
Does exercise stress testing identify electrocardiographic variables associated with prior arrhythmic events in patients with type 1 Brugada syndrome?
Case-Control (n=36)
Does exercise stress testing identify electrocardiographic variables associated with prior arrhythmic events in patients with type 1 Brugada syndrome?
An impaired heart rate response at peak effort and during early recovery on an exercise stress test is associated with prior arrhythmic events in patients with type 1 Brugada syndrome.
Impaired heart rate response on exercise testing was associated with prior events in Brugada syndrome; hypothesis-generating and warrants prospective validation.
INTRODUCTION: Brugada syndrome (BS) is a genetic channelopathy characterized by an increased risk of sudden cardiac death (SCD) in the absence of structural heart disease. Prognostic stratification is necessary to determine which patients are candidates for implantable cardioverter defibrillator (ICD). The present study aims to evaluate EKG changes during exercise stress tests in patients with BS and to identify any poor prognosis variables. METHODS: This was an observational, case-control study. Three comparison groups were created: patients with Type 1 BS with or without prior arrhythmic events (BE and BNoE subgroups) and age- and sex-matched healthy individuals. Patients underwent EST and electrocardiographic variables were analyzed. RESULTS: The study recruited 36 patients with type 1 BS, 12 with prior Event (BE) and 24 without (BNoE). Patients in the BE group, in all postexercise recordings, had lower heart rates, notably in the first minute. A significant difference was also observed in the HR drop in the recovery phase, with a greater drop in relation to maximum HR in the first minute in the group of patients who had events. CONCLUSION: BS patients with prior events had a lower capacity to increase heart rate at peak effort and a greater proportional drop in the recovery phase. No relationship was observed between the occurrence of arrhythmic events and ST-segment elevation during the exercise test.
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Miná et al. (2024) conducted a case-control in Brugada syndrome Type I (n=36). Exercise stress test vs. Patients without prior events and healthy individuals was evaluated on EKG changes during exercise stress tests (heart rate and ST-segment). Brugada syndrome patients with prior events had a lower capacity to increase heart rate at peak effort and a greater proportional drop in the recovery phase during exercise stress testing.
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