Right Ventricular Longitudinal Conduction Delay in Patients with Brugada Syndrome

Figures

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  Fig. 1. Electrical mapping of the RV endocardium was performed during RV endocardial stimulation using two quadripolar mapping catheters. The RVA catheter is located at the RVA. The RVOT catheter is placed along the long axis of the RVOT. Pacing and mapping were performed from the distal electrode pair. (A) Right anterior oblique view. (B) Left anterior oblique view. RV = right ventricle, RVA = right ventricular apex, RVOT = right ventricular outflow tract.

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  Fig. 2. The stimulation was performed at twice the diastolic threshold using a drive train of eight stimuli at basic cycle lengths of 600, 500, and 400 ms in the RVOT and RVA. (A) RVA-to-RVOT conduction time. (B) RVOT-to-RVA conduction time. The conduction time was defined as the interval from the stimulation to the intrinsic activation deflection in the endocardial bipolar electrogram. aVR = augmented vector right, aVL = augmented vector left, aVF = augmented vector foot, RVA = right ventricular apex, RVOT = right ventricular outflow tract.

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  Fig. 3. Conduction time in BrS and control. (A) RVA-to-RVOT (upward) conduction time. (B) RVOT-to-RVA (downward) conduction time. The RVA-to-RVOT (upward) conduction time in patients with BrS was significantly longer than in the control. The patients with ICD implantation were presented with dotted line and the patients without ICD implantation were presented with solid line. RVA = right ventricular apex, RVOT = right ventricular outflow tract, BrS = Brugada syndrome, ICD = implantable cardioverter defibrillator, S1 = stimuli.

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  Fig. 4. Plotting of the conduction time and BrS ST-segment amplitudes at the electrophysiology study. It shows an almost linear correlation except for one outlier. BrS = Brugada syndrome, RVA-OT = right ventricular apex to outflow tract, RVOT-A = right ventricular outflow tract to apex, ECG = electrocardiogram.