Key result
Advanced ECG techniques enhance diagnostic value for Brugada syndrome and arrhythmias.
Advanced ECG techniques, including modified electrode positions, ajmaline provocation, signal-averaged ECGs, and body surface mapping, can enhance diagnostic value for specific arrhythmogenic conditions compared to standard 12-lead ECG.
May support selective use in suspected cases; leaves open prospective validation before practice change.
Over the course of nearly a century, the 12-lead ECG has proven to be a valuable investigation in the diagnosis and assessment of a wide range of conditions. Like all tests, it has limitations. However, in certain circumstances, and in relation to particular conditions, modification of the standard ECG recording procedure can greatly increase the diagnostic value of the test. The authors look at how modified chest electrode positions and an ajmaline provocation test can unmask Brugada syndrome that is not evident from the standard ECG; how high-resolution signal-averaged ECGs may reveal late ventricular potentials that suggest an increased risk of malignant arrhythmias or the presence of arrhythmogenic right ventricular cardiomyopathy; and how multi-site body surface mapping may prove to be of value, particularly when combined with cardiac imaging, in elucidating the origin, and guiding the curative treatment, of certain arrhythmias.
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Richley et al. (2018) conducted a review in Arrhythmias, Brugada syndrome, arrhythmogenic right ventricular cardiomyopathy. Advanced ECG techniques vs. Standard 12-lead ECG was evaluated. Advanced ECG techniques, including modified electrode positions, ajmaline provocation, and signal-averaged ECGs, can enhance diagnostic value for conditions like Brugada syndrome and arrhythmias.
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