In Vivo Mapping of Human Ventricular Fibrillation in Brugada Syndrome: The Role of Repolarization Heterogeneity.

Autor:	Pannone L; Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart (L.P., D.G.D.R., P.V., A. Sorgente, A.D.M., G.V., M.C.F., G.T., I.E., P.-A.C., I.O., G.B., A.A., E.S., G.P., J.S., A.G., P.B., G.B.C., A. Sarkozy, C.d.A.), Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Belgium., Della Rocca DG; Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart (L.P., D.G.D.R., P.V., A. Sorgente, A.D.M., G.V., M.C.F., G.T., I.E., P.-A.C., I.O., G.B., A.A., E.S., G.P., J.S., A.G., P.B., G.B.C., A. Sarkozy, C.d.A.), Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Belgium., Vergara P; Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart (L.P., D.G.D.R., P.V., A. Sorgente, A.D.M., G.V., M.C.F., G.T., I.E., P.-A.C., I.O., G.B., A.A., E.S., G.P., J.S., A.G., P.B., G.B.C., A. Sarkozy, C.d.A.), Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Belgium., Sorgente A; Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart (L.P., D.G.D.R., P.V., A. Sorgente, A.D.M., G.V., M.C.F., G.T., I.E., P.-A.C., I.O., G.B., A.A., E.S., G.P., J.S., A.G., P.B., G.B.C., A. Sarkozy, C.d.A.), Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Belgium., Del Monte A; Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart (L.P., D.G.D.R., P.V., A. Sorgente, A.D.M., G.V., M.C.F., G.T., I.E., P.-A.C., I.O., G.B., A.A., E.S., G.P., J.S., A.G., P.B., G.B.C., A. Sarkozy, C.d.A.), Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Belgium., Vetta G; Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart (L.P., D.G.D.R., P.V., A. Sorgente, A.D.M., G.V., M.C.F., G.T., I.E., P.-A.C., I.O., G.B., A.A., E.S., G.P., J.S., A.G., P.B., G.B.C., A. Sarkozy, C.d.A.), Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Belgium., Cespon Fernandez M; Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart (L.P., D.G.D.R., P.V., A. Sorgente, A.D.M., G.V., M.C.F., G.T., I.E., P.-A.C., I.O., G.B., A.A., E.S., G.P., J.S., A.G., P.B., G.B.C., A. Sarkozy, C.d.A.), Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Belgium., Talevi G; Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart (L.P., D.G.D.R., P.V., A. Sorgente, A.D.M., G.V., M.C.F., G.T., I.E., P.-A.C., I.O., G.B., A.A., E.S., G.P., J.S., A.G., P.B., G.B.C., A. Sarkozy, C.d.A.), Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Belgium., Eltsov I; Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart (L.P., D.G.D.R., P.V., A. Sorgente, A.D.M., G.V., M.C.F., G.T., I.E., P.-A.C., I.O., G.B., A.A., E.S., G.P., J.S., A.G., P.B., G.B.C., A. Sarkozy, C.d.A.), Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Belgium., Calburean PA; Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart (L.P., D.G.D.R., P.V., A. Sorgente, A.D.M., G.V., M.C.F., G.T., I.E., P.-A.C., I.O., G.B., A.A., E.S., G.P., J.S., A.G., P.B., G.B.C., A. Sarkozy, C.d.A.), Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Belgium., Overeinder I; Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart (L.P., D.G.D.R., P.V., A. Sorgente, A.D.M., G.V., M.C.F., G.T., I.E., P.-A.C., I.O., G.B., A.A., E.S., G.P., J.S., A.G., P.B., G.B.C., A. Sarkozy, C.d.A.), Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Belgium., Bala G; Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart (L.P., D.G.D.R., P.V., A. Sorgente, A.D.M., G.V., M.C.F., G.T., I.E., P.-A.C., I.O., G.B., A.A., E.S., G.P., J.S., A.G., P.B., G.B.C., A. Sarkozy, C.d.A.), Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Belgium., Almorad A; Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart (L.P., D.G.D.R., P.V., A. Sorgente, A.D.M., G.V., M.C.F., G.T., I.E., P.-A.C., I.O., G.B., A.A., E.S., G.P., J.S., A.G., P.B., G.B.C., A. Sarkozy, C.d.A.), Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Belgium., Ströker E; Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart (L.P., D.G.D.R., P.V., A. Sorgente, A.D.M., G.V., M.C.F., G.T., I.E., P.-A.C., I.O., G.B., A.A., E.S., G.P., J.S., A.G., P.B., G.B.C., A. Sarkozy, C.d.A.), Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Belgium., Pappaert G; Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart (L.P., D.G.D.R., P.V., A. Sorgente, A.D.M., G.V., M.C.F., G.T., I.E., P.-A.C., I.O., G.B., A.A., E.S., G.P., J.S., A.G., P.B., G.B.C., A. Sarkozy, C.d.A.), Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Belgium., Sieira J; Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart (L.P., D.G.D.R., P.V., A. Sorgente, A.D.M., G.V., M.C.F., G.T., I.E., P.-A.C., I.O., G.B., A.A., E.S., G.P., J.S., A.G., P.B., G.B.C., A. Sarkozy, C.d.A.), Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Belgium., de Ravel T; Centre for Medical Genetics (T.d.R., S.V.D.), Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Clinical Sciences, Research Group Reproduction and Genetics, Belgium., Van Dooren S; Centre for Medical Genetics (T.d.R., S.V.D.), Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Clinical Sciences, Research Group Reproduction and Genetics, Belgium.; Brussels Interuniversity Genomics High Throughput Core (S.V.D.), Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Clinical Sciences, Research Group Reproduction and Genetics, Belgium., Gharaviri A; Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart (L.P., D.G.D.R., P.V., A. Sorgente, A.D.M., G.V., M.C.F., G.T., I.E., P.-A.C., I.O., G.B., A.A., E.S., G.P., J.S., A.G., P.B., G.B.C., A. Sarkozy, C.d.A.), Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Belgium., La Meir M; Cardiac Surgery Department (M.L.M.), Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Belgium., Brugada P; Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart (L.P., D.G.D.R., P.V., A. Sorgente, A.D.M., G.V., M.C.F., G.T., I.E., P.-A.C., I.O., G.B., A.A., E.S., G.P., J.S., A.G., P.B., G.B.C., A. Sarkozy, C.d.A.), Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Belgium., Chierchia GB; Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart (L.P., D.G.D.R., P.V., A. Sorgente, A.D.M., G.V., M.C.F., G.T., I.E., P.-A.C., I.O., G.B., A.A., E.S., G.P., J.S., A.G., P.B., G.B.C., A. Sarkozy, C.d.A.), Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Belgium., Sarkozy A; Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart (L.P., D.G.D.R., P.V., A. Sorgente, A.D.M., G.V., M.C.F., G.T., I.E., P.-A.C., I.O., G.B., A.A., E.S., G.P., J.S., A.G., P.B., G.B.C., A. Sarkozy, C.d.A.), Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Belgium., de Asmundis C; Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, European Reference Networks Guard-Heart (L.P., D.G.D.R., P.V., A. Sorgente, A.D.M., G.V., M.C.F., G.T., I.E., P.-A.C., I.O., G.B., A.A., E.S., G.P., J.S., A.G., P.B., G.B.C., A. Sarkozy, C.d.A.), Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Belgium.
Jazyk:	angličtina
Zdroj:	Circulation. Arrhythmia and electrophysiology [Circ Arrhythm Electrophysiol] 2024 Dec; Vol. 17 (12), pp. e013290. Date of Electronic Publication: 2024 Dec 03.
DOI:	10.1161/CIRCEP.124.013290
Abstrakt:	Background: Brugada syndrome (BrS) is associated with ventricular fibrillation (VF). Different VF mechanisms have been described, and repolarization gradients were associated with VF in a BrS model. The aim of this study is to map VF in BrS with ECG imaging. Furthermore, spatial correlation between sinus rhythm maps and VF maps was evaluated. Methods: Inclusion criteria were (1) BrS diagnosis and (2) VF mapped with ECG imaging during right ventricle outflow tract ablation. VF mechanism was classified into (1) rotational, (2) focal, and (3) irregular. For comparison, 6 controls were enrolled. The following sinus rhythm maps were performed: activation, recovery time, and activation-recovery interval time. Spatial overlap between steep repolarization gradients (cliffs) at recovery time and activation-recovery interval time maps and initiating VF rotational activity was evaluated with photogrammetry. Results: A total of 28 VF maps in 21 patients with BrS were analyzed. In the first ≈7 seconds of VF, rotational, focal, and irregular mechanisms were found. In 19 patients with BrS (90.5%) and none of the controls, a right ventricle outflow tract repolarization cliff only was found. In all these patients, the singularity point of the first initiating rotational VF activity spatially overlapped with the right ventricle outflow tract cliff. Abolition of right ventricle outflow tract repolarization cliffs was confirmed in all but 2 patients (94.3%). In one patient with recurrence, VF was mapped on the anterior right ventricle over a cliff that was not targeted at the first ablation procedure. Conclusions: In patients with BrS, repolarization heterogeneity has a critical role in VF. Repolarization cliffs might be a therapeutic target in VF ablation. Competing Interests: Dr Sorgente received research grants from Daiichi Sankyo and Bayer; he received speaker fees from Menarini and Bayer. Dr La Meir is a consultant for AtriCure. Dr Chierchia received compensation for teaching purposes and proctoring from Medtronic, Abbott, Biotronik, and Boston Scientific. Dr Sarkozy is a consultant for Biosense Webster and Medtronic and received speaker fees from Biosense Webster, Biotronik, Pfizer, and Microport. Dr de Asmundis receives research grants on behalf of the center from Biotronik, Medtronic, Abbott, Microport, Boston Scientific, and AtriCure. Dr de Asmundis received compensation for teaching purposes and proctoring from Medtronic, Abbott, Biotronik, MicroPort, Boston Scientific, AtriCure, and Daiichi Sankyo. The other authors report no conflicts.
Databáze:	MEDLINE
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