Can specific ECG markers identify a pharmacologically induced type 1 Brugada pattern? Insights from a large, single-center cohort.

Autor: Occhetta E; Cardiology Division, Ospedale S. Andrea, Vercelli, Italy. Electronic address: eraldo864@gmail.com., De Vecchi F; Cardiology Division, Ospedale S. Andrea, Vercelli, Italy; University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy., Barbonaglia L; Cardiology Division, Ospedale S. Andrea, Vercelli, Italy., Devecchi C; Cardiology Division, Ospedale S. Andrea, Vercelli, Italy; University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy., Matta M; Cardiology Division, Ospedale S. Andrea, Vercelli, Italy; Cardiology Division, University of Turin, Turin, Italy., Malacrida M; Boston Scientific Inc., Milan, Italy., Patti G; University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy., Rametta F; Cardiology Division, Ospedale S. Andrea, Vercelli, Italy.
Jazyk: angličtina
Zdroj: Journal of electrocardiology [J Electrocardiol] 2023 Nov-Dec; Vol. 81, pp. 123-131. Date of Electronic Publication: 2023 Sep 02.
DOI: 10.1016/j.jelectrocard.2023.08.017
Abstrakt: Background: In patients with a type 2 or 3 Brugada pattern, the pharmacological (IC drugs) induction of a type 1 pattern confirms the diagnosis of Brugada syndrome.
Objective: To evaluate the value of various ECG markers in predicting IC drug test results.
Methods: We retrospectively analysed 443 consecutive patients referred to our Center (from January 2010 to December 2019) to undergo Ajmaline/Flecainide testing; all had a type 2 or 3 Brugada pattern or were relatives with Brugada syndrome. Clinical parameters and ECG markers (r 1 V 1 and SV 6 duration and amplitude, QRSV 1 /QRSV 6 duration, V 1 and V 2 ST amplitude) were independently evaluated for their association to pharmacological test positivity, and a logistic regression model was applied.
Results: The drug test was positive in 151 (34%) patients. On multivariate logistic regression analysis, age > 45 years, female gender, HR >60 bpm, QRSV 1 /QRSV 6 duration >1 and non-isoelectric pattern in V 2 were associated with a positive test. The percentage of patients who tested positive increased according to the presence of the above ECG markers (from 11.3% in the absence to 57.6% in the presence of both factors). During long-term follow-up, the clinical event rate was higher in patients with predictive ECG markers and very low in those without.
Conclusions: In our population we confirmed the ability of QRSV 1 /QRSV 6 duration >1 and of a non-isoelectric pattern in V 2 to predict a pharmacologically induced type 1 Brugada pattern. Patients with neither of these ECG markers had a rather low event rate during follow-up.
Competing Interests: Declaration of Competing Interest All the Authors have no conflicts of interest.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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