Significance of Exercise-Related Ventricular Arrhythmias in Patients With Brugada Syndrome
| Autor: | Tomonari Kimura, Saori Asada, Yoshimasa Morimoto, Atsuyuki Watanabe, Hiroshi Ito, Masakazu Miyamoto, Hiroshi Morita, Nobuhiro Nishii, Koji Nakagawa, Tomofumi Mizuno |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Sinus tachycardia Vagal nerve exercise test sudden death 030204 cardiovascular system & hematology premature ventricular contractions Sudden death Sudden Cardiac Death 03 medical and health sciences Electrocardiography Young Adult 0302 clinical medicine Internal medicine medicine Humans In patient Arrhythmia and Electrophysiology Brugada syndrome 030212 general & internal medicine Treadmill exercise test Exercise Aged Original Research business.industry Incidence Early recovery Middle Aged medicine.disease ventricular fibrillation Ventricular Premature Complexes Ventricular fibrillation Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business Exercise Testing |
| Zdroj: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| ISSN: | 2047-9980 |
| Popis: | Background Sinus tachycardia during exercise attenuates ST‐segment elevation in patients with Brugada syndrome, whereas ST‐segment augmentation after an exercise test is a high‐risk sign. Some patients have premature ventricular contractions (PVCs) related to exercise, but the significance of exercise‐related PVCs in patients with Brugada syndrome is still unknown. The objective of this study was to determine the significance of exercise‐related PVCs for predicting occurrence of ventricular fibrillation (VF) in patients with Brugada syndrome. Methods and Results The subjects were 307 patients with Brugada syndrome who performed a treadmill exercise test. We evaluated the occurrence of PVCs at rest, during exercise and at the peak of exercise, and during recovery after exercise (0–5 minutes). We followed the patients for 92±68 months and evaluated the occurrence of VF. PVCs occurred in 82 patients (27%) at the time of treadmill exercise test: PVCs appeared at rest in 14 patients (4%), during exercise in 60 patients (20%), immediately after exercise (0–1.5 minutes) in 28 patients (9%), early after exercise (1.5–3 minutes) in 18 patients (6%), and late after exercise (3–5 minutes) in 12 patients (4%). Thirty patients experienced VF during follow‐up. Multivariable analysis including symptoms, spontaneous type 1 ECG, and PVCs in the early recovery phase showed that these factors were independently associated with VF events during follow‐up. Conclusions PVCs early after an exercise test are associated with future occurrence of VF events. Rebound of vagal nerve activity at the early recovery phase would promote ST‐segment augmentation and PVCs in high‐risk patients with Brugada syndrome. |
| Databáze: | OpenAIRE |
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