Local Left Ventricular Epicardial J Waves and Late Potentials in Brugada Syndrome Patients with Inferolateral Early Repolarization Pattern

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Brugada syndrome (n=29). Intervention: Left ventricular epicardial electrogram recording vs. Control subjects. Primary outcome: Presence of prominent J waves and potentials after the QRS complex at the left ventricular epicardium.

Key Result

Prominent J waves and potentials after the QRS complex were recorded at the left ventricular epicardium in 3 of 12 Brugada syndrome patients with global early repolarization patterns, compared to 0 of 17 control subjects.

Study Design

Type

Observational (n=29)

Multicenter

PICO

Population

Brugada syndrome (n=29)

Intervention / Comparator

Left ventricular epicardial electrogram recording vs Control subjects

Primary Outcome

Presence of prominent J waves and potentials after the QRS complex at the left ventricular epicardium

Main Result

Absolute Event Rate: 25% vs 0%

Limitations

Small number of Brugada syndrome patients, especially those with a global early repolarization pattern
Unipolar recordings are influenced by far-field electrical activity
Epicardial recording was not performed on the anterior and inferior left ventricle
Small and heterogeneous control group that was not matched with the Brugada syndrome patients
Left ventricular endocardial mapping was not performed in the majority of patients due to ethical concerns
Programmed epicardial pacing on the left ventricle was not performed

Abstract

We recorded prominent J waves in unipolar electrogram and potentials after QRS complex in bipolar electrogram at the LV epicardium in BrS patients with global ER pattern. The prominent J waves coincided with the potentials after QRS complex and the inferolateral ER pattern on ECG. The characteristics of the inferolateral ER pattern on ECG in these patients primarily represent depolarization feature.

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Cite This Study

Nagase et al. (Thu,) conducted a observational in Brugada syndrome (n=29). Left ventricular epicardial electrogram recording vs. Control subjects was evaluated on Presence of prominent J waves and potentials after the QRS complex at the left ventricular epicardium. Prominent J waves and potentials after the QRS complex were recorded at the left ventricular epicardium in 3 of 12 Brugada syndrome patients with global early repolarization patterns, compared to 0 of 17 control subjects.

synapsesocial.com/papers/6a0cfb7332f3c40b5ccbb046 https://doi.org/https://doi.org/10.3389/fphys.2017.00014

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