Key result
Symptomatic Brugada syndrome patients exhibited a significantly higher dominant frequency of induced ventricular fibrillation across phases compared to asymptomatic patients.
Why the study?
Does the dominant frequency of induced ventricular fibrillation differ between symptomatic and asymptomatic patients with Brugada syndrome?
Observational (n=28)
No
Does the dominant frequency of induced ventricular fibrillation differ between symptomatic and asymptomatic patients with Brugada syndrome?
Symptomatic Brugada syndrome patients exhibit a shorter ventricular fibrillation cycle length and higher dominant frequency during induced VF compared to asymptomatic patients, suggesting a different electrophysiological substrate.
Answers are grounded in this paper and cite their sources.
May aid Brugada risk stratification; hypothesis-generating and requires prospective validation before any practice change.
BACKGROUND: Limited information is available on the ventricular fibrillation (VF) spectrum in Brugada syndrome (BS) patients. We clarified differences in the VF cycle length (CL) using fast-Fourier transformation (FFT) analysis in symptomatic and asymptomatic BS patients. METHODS AND RESULTS: VF was induced by pacing from the right ventricular (RV) apex and/or RV outflow tract (RVOT) for >8s. A 4096-point FFT analysis of results from 28 male BS patients (51.1 ± 13.7 years old) was performed. Dominant frequency (DF) from phases 1 (4s) to 6 was obtained at 2-s intervals. The average DF from surface and intracardiac electrograms (ECG: DF(ECG); ICE: DF(ICE,), respectively) was compared between symptomatic and asymptomatic patients. Symptomatic patients had a significantly shorter effective refractory period at a CL of 600 ms at the RVOT than asymptomatic patients. DF(ECG) significantly increased with phase (5.64 ± 0.32 Hz in phase 1 to 6.16 ± 0.52 Hz in phase 6) and was significantly higher in symptomatic patients than in asymptomatic patients. DF(ICE) had the same characteristics as DF(ECG). CONCLUSIONS: Induced VF in BS patients can be characterized using FFT analysis. Our data support the hypothesis that symptomatic patients have a significantly shorter VF CL than asymptomatic patients.
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Hiratsuka et al. (2012) conducted an observational in Brugada syndrome (n=28). Symptomatic Brugada syndrome vs. Asymptomatic Brugada syndrome was evaluated on Dominant frequency from surface ECG (DFECG) across phases 1 to 6 (p=0.022). Symptomatic Brugada syndrome patients exhibited a significantly higher dominant frequency of induced ventricular fibrillation across phases compared to asymptomatic patients.
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