What question did this study set out to answer?

To evaluate the electrocardiographic and electrophysiologic characteristics associated with programmed ventricular stimulation-induced ventricular fibrillation in patients presenting with Brugada syndrome.

January 1, 2007Circulation JournalOpen Access

Electrocardiographic and Electrophysiologic Characteristics in Patients With Brugada Type Electrocardiogram and Inducible Ventricular Fibrillation Single Center Experience

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Brugada syndrome (n=34). Intervention: Programmed ventricular stimulation vs. Asymptomatic patients. Primary outcome: PVS-induced ventricular fibrillation (p=<0.05).

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Key result

Programmed ventricular stimulation induced ventricular fibrillation in 91% of symptomatic and 74% of asymptomatic patients with Brugada syndrome (p<0.05), but did not predict future arrhythmic events.

Why the study?

Does programmed ventricular stimulation-induced ventricular fibrillation predict arrhythmic events in patients with Brugada-type ECG?

Population

34 consecutive patients with a Brugada-type electrocardiogram, including 11 symptomatic and 23 asymptomatic…

Design

Cohort

Follow-up

mean 47.1±33.7 months

Authors

KOKimie OhkuboNihon University IWIchiro WatanabeNihon University YTYasuhiro TakagiMukogawa Women's University

Discussion

Member takes

Implication

Inducibility should not guide risk stratification in Brugada syndrome; leaves open need for validated predictors in prospective cohorts.

Key Points

To evaluate the electrocardiographic and electrophysiologic characteristics associated with programmed ventricular stimulation-induced ventricular fibrillation in patients presenting with Brugada syndrome.
Enrolled 34 patients with Brugada-type ECG patterns, categorized into type 1 (n=12), type 2 (n=12), and type 3 (n=10).
Conducted programmed ventricular stimulation using up to two ventricular premature beats from the right ventricular apex and outflow tract at cycle lengths of 600 and 400 ms, followed by clinical tracking for 47.1 ± 33.7 months.
Ventricular fibrillation was induced in 74% (17/23) of asymptomatic patients compared to 91% (10/11) of symptomatic patients (p < 0.05).
Over an average follow-up period of 47.1 ± 33.7 months, 1 sudden death occurred among the 27 patients with inducible ventricular fibrillation, whereas 0 occurred among the 7 patients without inducible ventricular fibrillation.

Study Design

Type

Observational (n=34)

Multicenter

Structured PICO

Does programmed ventricular stimulation-induced ventricular fibrillation predict arrhythmic events in patients with Brugada-type ECG?

Population

34 consecutive patients (33 men, 1 woman, mean age 52±13 years) with a Brugada-type electrocardiogram (12 type 1, 12 type 2, 10 type 3), including 11 symptomatic and 23 asymptomatic patients.

Intervention

Programmed ventricular stimulation (PVS) with up to 2 ventricular premature beats from the right ventricular apex and outflow tract at 2 basic cycle lengths (600 and 400 ms).

Outcome

Inducibility of ventricular fibrillation (VF) and its correlation with clinical presentation and arrhythmic events during follow-up.surrogate

Main Result

Absolute Event Rate: 91% vs 74%

p-value: p=<0.05

In patients with Brugada-type ECG, the inducibility of ventricular fibrillation during electrophysiologic study is high but does not correlate with clinical presentation or predict future arrhythmic events.

Limitations

Small patient population
Relatively short and variable follow-up periods
Very low number of events leading to lack of statistical power for survival analysis

Cite This Study

Ohkubo et al. (2007) conducted an observational in Brugada syndrome (n=34). Programmed ventricular stimulation vs. Asymptomatic patients was evaluated on PVS-induced ventricular fibrillation (p=<0.05). Programmed ventricular stimulation induced ventricular fibrillation in 91% of symptomatic and 74% of asymptomatic patients with Brugada syndrome (p<0.05), but did not predict future arrhythmic events.

synapsesocial.com/papers/6a160c58366ced26f1b569b2 https://doi.org/10.1253/circj.71.1437

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Electrocardiographic and Electrophysiologic Characteristics in Patients With Brugada Type Electrocardiogram and Inducible Ventricular Fibrillation Single Center Experience

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Electrocardiographic and Electrophysiologic Characteristics in Patients With Brugada Type Electrocardiogram and Inducible Ventricular Fibrillation Single Center Experience

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider