Key result
An S wave width ≥0.08 s in V1 and ST elevation ≥0.18 mV in V2 identified ventricular fibrillation in Brugada syndrome with 100% sensitivity and 100% negative predictive value.
Why the study?
Do specific ECG criteria (S wave width in V1 and ST elevation in V2) identify high-risk Brugada syndrome patients with a history of ventricular fibrillation?
Observational (n=60)
Blinded
Yes
Do specific ECG criteria (S wave width in V1 and ST elevation in V2) identify high-risk Brugada syndrome patients with a history of ventricular fibrillation?
An S wave width ≥0.08 s in lead V1 and ST elevation ≥0.18 mV in lead V2 are highly sensitive markers that may help identify Brugada syndrome patients at high risk for ventricular fibrillation.
Answers are grounded in this paper and cite their sources.
Should not yet alter risk stratification in Brugada syndrome; leaves open prospective validation of these ECG criteria.
To identify high-risk patients with Brugada syndrome, the present study reviewed 60 standard 12-lead electrocardiograms from 60 patients collected by the Japanese Brugada syndrome registry. Under blinded conditions, the S wave of lead V(1) was measured from the tip of r to r', and the amplitude of the ST segment in lead V(2) was measured at 0.08 s from the J point. In patients with ventricular fibrillation (n=17), the S wave was significantly longer in V(1) (0.085+/-0.007 s vs 0.075+/-0.011 s, p=0.001), and ST segment elevation in V(2) was significantly greater (0.323+/-0.133 mV vs 0.236+/-0.129 mV, p=0.012) than in patients without fibrillation. An S wave width of 0.08 s or more in V(1) had a positive predictive value of 40.5% and negative predictive value of 100% for ventricular fibrillation, with 100% sensitivity. ST elevation of 0.18 mV or more in V(2) had a positive predictive value of 37.8% and a negative predictive value of 100% for ventricular fibrillation, with 100% sensitivity. Both an S wave width > or =0.08 s in V(1) and ST elevation > or =0.18 mV in V(2) were highly specific indicators of ventricular fibrillation and are proposed as new criteria for high-risk Brugada syndrome.
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Atarashi et al. (2002) conducted an observational in Brugada syndrome (n=60). ECG criteria (S wave width in V1 and ST elevation in V2) vs. Patients without ventricular fibrillation was evaluated on Ventricular fibrillation (p=0.001). An S wave width ≥0.08 s in V1 and ST elevation ≥0.18 mV in V2 identified ventricular fibrillation in Brugada syndrome with 100% sensitivity and 100% negative predictive value.
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