Prevalence and characteristics of the Brugada electrocardiogram pattern in patients with arrhythmogenic right ventricular cardiomyopathy. Issue 5 (30th August 2021)

• Record Type: Journal Article
• Authors: Ueda, Nobuhiko; Nagase, Satoshi; Kataoka, Naoya; Nakajima, Kenzaburo; Kamakura, Tsukasa; Wada, Mitsuru; Yamagata, Kenichiro; Ishibashi, Kohei; Inoue, Yuko; Miyamoto, Koji; Noda, Takashi; Aiba, Takeshi; Izumi, Chisato; Noguchi, Teruo; Ohno, Seiko; Kusano, Kengo
• Is Part Of: Journal of arrhythmia. Volume 37:Issue 5(2021)
• Page Start: 1173
• Page End: 1183
• Publication Date: 2021-08-30
• Subjects: arrhythmogenic right ventricular cardiomyopathy -- Brugada syndrome -- cardiac death -- depolarization abnormality -- heart failure; Arrhythmia -- Periodicals; Cardiac pacing -- Periodicals; Arrhythmias, Cardiac; Arrhythmia; Cardiac pacing; Periodicals; Electronic journals; Periodicals; 616.128
• DOI: 10.1002/joa3.12628
• Languages: English
• ISSNs: 1880-4276

Abstract

Abstract: Background: Despite distinct pathophysiology, arrhythmogenic right ventricular cardiomyopathy (ARVC) and Brugada syndrome (BrS) exhibit overlapping phenotypes. We investigated the prevalence and characteristics of the Brugada electrocardiogram (ECG) pattern in ARVC patients. Methods: A total of 114 ARVC patients fulfilling the revised Task Force Criteria were enrolled. The Brugada ECG pattern was evaluated according to the consensus report on right precordial leads, and 1141 ECGs (median, 1; interquartile range, 1‐16 ECGs/patient) were analyzed. Results: Five patients (4%) showed a Brugada ECG pattern, which disappeared in four patients with ECGs recorded more than 2 years afterward. ARVC patients with the Brugada ECG pattern had a longer PQ interval (220 ± 62 ms vs 180 ± 35 ms, P = .02) and longer QRS duration (138 ± 25 ms vs 102 ± 23 ms, P < .001) than patients without the pattern. During follow‐up (median, 11.4; interquartile range, 5.5‐17.1 years), 19 ARVC patients experienced cardiac death and 29 experienced heart failure (HF) hospitalization. Kaplan‐Meier analysis determined that the Brugada ECG pattern increased the risk of cardiac death and HF hospitalization (log‐rank; P < .001, P < .001 respectively). The mean J‐point and S‐wave amplitudes of the Brugada ECG pattern were 0.29 ± 0.05 mV and 0.34 ± 0.21 mV, respectively, which were significantly lower than those of 26 age‐matched BrS patients with a previous ventricular fibrillation episode (0.66 ± 0.33 mV, P < .001 and 0.67 ± 0.39 mV, P = .02 respectively). Conclusion: The Brugada ECG pattern was infrequently encountered, was transient in ARVC patients, and was associated with a longer PQ interval, longer QRS duration, and cardiac events. Abstract : Despite distinct pathophysiology, several reports have suggested overlapping phenotypes between arrhythmogenic right ventricular cardiomyopathy (ARVC) and Brugada syndrome. A Brugada ECG pattern was transiently recorded at least once in 5 out of 114 ARVC patients (4%). A transient Brugada ECG pattern (*) was associated with cardiac death in patients with ARVC.