Prevalence of spontaneous type I ECG pattern, syncope, and other risk markers in sudden cardiac arrest survivors with Brugada syndrome

Autor: David C. Lefroy, Norman Qureshi, Prapa Kanagaratnam, Michael Koa-Wing, Fu Siong Ng, Sian Jones, Kevin M.W. Leong, D W Davies, Nicholas S. Peters, Phang Boon Lim, Nick Linton, Ji-Jian Chow, Zachary I. Whinnett, Amanda Varnava
Přispěvatelé: Daniel Bagshaw Memorial Trust, British Heart Foundation, Rosetrees Trust, Imperial College Healthcare NHS Trust- BRC Funding
Rok vydání: 2019
Předmět:
STIMULATION
Technology
medicine.medical_specialty
Cardiac & Cardiovascular Systems
Benign early repolarization
MULTICENTER
EXERCISE
risk stratification
030204 cardiovascular system & hematology
Ventricular tachycardia
CONSENSUS CONFERENCE
03 medical and health sciences
Engineering
0302 clinical medicine
0903 Biomedical Engineering
sudden cardiac arrest
STRATIFICATION
Internal medicine
medicine
Palpitations
Brugada syndrome
ST-SEGMENT ELEVATION
030212 general & internal medicine
Engineering
Biomedical
J wave
Science & Technology
business.industry
J-WAVE
DEATH
1103 Clinical Sciences
Sudden cardiac arrest
General Medicine
medicine.disease
IDIOPATHIC VENTRICULAR-FIBRILLATION
Signal-averaged electrocardiogram
Cardiovascular System & Hematology
Ventricular fibrillation
Cardiovascular System & Cardiology
ELECTROCARDIOGRAPHIC PARAMETERS
Cardiology
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Life Sciences & Biomedicine
Zdroj: Pacing and Clinical Electrophysiology. 42:257-264
ISSN: 0147-8389
DOI: 10.1111/pace.13587
Popis: Introduction A spontaneous type I electrocardiogram (ECG) pattern and/or unheralded syncope are conventionally used as risk markers for primary prevention of sudden cardiac arrest/death (SCA/SCD) in Brugada syndrome (BrS). In this study, we determine the prevalence of conventional and newer markers of risk in those with and without previous aborted SCA events. Methods All patients with BrS were identified at our institute. History of symptoms was obtained from medical tests or from interviews. Other markers of risk were also obtained, such as presence of (1) spontaneous type I pattern, (2) fractionated QRS (fQRS), (3) early repolarization (ER) pattern, (4) late potentials on signal‐averaged ECG (SAECG), and (5) response to programmed electrical stimulation. Results In 133 patients with Bars, 10 (7%) patients (mean age = 39 ± 11 years; nine males) were identified with a previous ventricular fibrillation/ventricular tachycardia episode (n = 8) or requiring cardio‐pulmonary resuscitation (n = 2). None of these patients had a prior history of syncope before their SCA event. Only two (20%) patients reported a history of palpitations or dizziness. None had apneic breathing and three (30%) patients had a family history of SCA. From their ECGs, a spontaneous pattern was only found in one (10%) of these patients. Further, 10% of patients had fQRS, 17% had late potentials on SAECG, 20% had deep S waves in lead I, and 10% had an ER pattern in the peripheral leads. No significant differences were observed in the non‐SCA group. Conclusion The majority of BrS patients with previous aborted SCA events did not have a spontaneous type I and/or prior history of syncope. Conventional and newer markers of risk appear to only have limited ability to predict SCA.
Databáze: OpenAIRE
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