Maximum QTc interval emerged as the most reliable non-invasive electrocardiography parameter with low heterogeneity (0% after sensitivity analysis) for predicting VT/VF in Brugada syndrome.
Meta-Analysis
Do markers of ventricular repolarization on ECG predict ventricular tachycardia/fibrillation in patients with Brugada syndrome?
Maximum QTc interval on ECG is a reliable non-invasive parameter with low heterogeneity for predicting VT/VF and sudden cardiac death in patients with Brugada syndrome.
BACKGROUND: Controversies surrounded the management of asymptomatic Brugada syndrome. Prognostication using electrophysiology study (EPS) is disputable. Non-invasive parameters may be a valuable additional tool for risk stratification. We aim to evaluate the use markers of ventricular repolarization including Tpeak-to-Tend (TpTe), Tpe Dispersion, TpTe/QT ratio, and QTc interval as additional non-invasive electrocardiography parameters for predicting ventricular tachycardia/fibrillation in patients with Brugada syndrome. METHODS: We performed a comprehensive search on TpTe, Tpe Dispersion, TpTe/QT ratio, and QTc interval as a predictor for ventricular tachycardia(VT)/fibrillation(VF)/aborted sudden cardiac death/appropriate ICD shock in patients with Brugada syndromes up until October 2018. RESULTS: 28%) were the most potential ECG parameters to predict VT/VF/AT/SCD. Tpe dispersion and TpTe/QT ratio have a high heterogeneity. Upon sensitivity analysis, there is no single study found to markedly affect heterogeneity of Tpe dispersion and TpTe/QT ratio. Removal of a study reduced maximum QTc interval heterogeneity to 0%. CONCLUSIONS: Measurement of TpTe interval, Tp-e dispersion, TpTe/QT ratio, and QTc interval on ECG emerge as a promising prognostication tool which needs further investigations with a more standardized method, outcome, and cut-off points. As for now, only maximum QTc interval has a reliable result with low heterogeneity sufficiently reliable for prognostication.
Pranata et al. (Sat,) conducted a meta-analysis in Brugada syndrome. Markers of ventricular repolarization (TpTe, Tpe Dispersion, TpTe/QT ratio, QTc interval) was evaluated on Ventricular tachycardia (VT) / fibrillation (VF) / aborted sudden cardiac death / appropriate ICD shock. Maximum QTc interval emerged as the most reliable non-invasive electrocardiography parameter with low heterogeneity (0% after sensitivity analysis) for predicting VT/VF in Brugada syndrome.
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