Key result
Underlying Brugada syndrome in AVNRT is linked to 9 specific ECG variables including interatrial block.
Why the study?
Coexistence of clinical AVNRT and drug-induced type 1 Brugada pattern has been reported, but baseline and tachycardia 12-lead ECG characteristics associated with underlying Brugada syndrome or pattern in these patients needed determination.
Which 12-lead ECG variables are associated with underlying Brugada syndrome or drug-induced Type 1 Brugada pattern in patients with slow/fast AVNRT?
Case-Control (n=173)
Which 12-lead ECG variables are associated with underlying Brugada syndrome or drug-induced Type 1 Brugada pattern in patients with slow/fast AVNRT?
Specific 12-lead ECG characteristics at baseline and during AVNRT can help identify patients with underlying Brugada syndrome or drug-induced Type 1 Brugada pattern.
Answers are grounded in this paper and cite their sources.
Associated ECG variables may flag Brugada syndrome in AVNRT; hypothesis-generating and requires prospective validation before clinical adoption.
Background The coexistence of clinical atrioventricular nodal reentrant tachycardia (AVNRT) and drug‐induced type 1 Brugada pattern (DI‐Type 1 BrP) has been previously reported. The present study was designed to determine the 12‐lead ECG characteristics at baseline and during AVNRT and to identify a subset of 12‐lead ECG variables of benefit associated with underlying Brugada syndrome (BrS)/DI‐Type 1 BrP among patients with slow/fast AVNRT. Methods A total of 40 (11 numerical/29 categorical) 12‐lead ECG parameters were analyzed and compared between patients with ( n = 69) and without ( n = 104) BrS/DI‐Type1‐BrP matched for age, female gender, body mass index, left ventricular ejection fraction and comorbid conditions. Five distinct types of ECG pattern (Type A/B/C/D/E) in V1–V2 leads during AVNRT were defined. Results A total of nine electrocardiographic variables, four at baseline, and five during AVNRT were identified. At baseline, patients with BrS/DI‐Type 1 BrP had higher prevalence of interatrial block, leftward shift of frontal plane QRS axis, the absence of normal QRS pattern (the presence of rSr’ pattern or type 2/3 Brugada pattern) in V1–V2 and QRS fragmentation in inferior leads compared to patients without BrS/DI‐Type 1 BrP. During AVNRT, patients with BrS/DI‐Type 1 BrP had higher prevalence of Type A ECG pattern (“coved‐type” ST‐segment elevation) in V1–V2, Type C ECG pattern (pseudo‐r’ deflection in V 1 and “RBBB‐like” pattern in V 2 ), pseudo‐r’ deflection in V 1 , QRS fragmentation in inferior leads and “isolated” QRS fragmentation/notching/slurring in aVL compared to patients without BrS/DI‐Type 1 BrP. Conclusions We identify several electrocardiographic variables that point to an underlying type 1 BrP among patients with slow/fast AVNRT.
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Hasdemir et al. (2022) conducted a case-control in slow/fast atrioventricular nodal reentrant tachycardia (AVNRT) (n=173). Presence of Brugada syndrome or drug-induced Type 1 Brugada pattern vs. Absence of Brugada syndrome or drug-induced Type 1 Brugada pattern was evaluated on 12-lead ECG characteristics at baseline and during AVNRT. Underlying Brugada syndrome in patients with AVNRT was associated with 9 specific ECG variables, including interatrial block, leftward QRS axis shift, and Type A ECG pattern in V1-V2 during AVNRT.
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