Abstract 2297: Arrhythmogenic Right Ventricular Dysplasia and Brugada syndrome: 3D ECG similarities and differences
Background: Similarities between Arrhythmogenic Right Ventricular Displasia (ARVD) and Brugada syndrome (BS) have been reported.
Objectives:To find a link between ARVD and BS and to provide a better distinction between these diseases, ventricular depolarization and repolarization abnormalities were quantified using 3D-ECG analysis.
Methods: 19 patients with BS (15 men; mean age = 43.3 ± 14.0 years) and 17 patients with ISFC/ESC criteria of ARVD (12 men; mean age = 37.1 ± 15.5 years) were evaluated. The control group consisted of 32 age-matched healthy subjects (24 men; mean age = 40.5 ± 9.1 years). Standard 12 lead ECG recordings were processed using a 3D analysis and conventional and spatio temporal measurements were extracted.
Results: The corrected QT interval measured at the end of the T-wave (QTec) was the same for both groups of patients (431.9 ± 42.2 ms for ARVD and 430.6 ± 22.2 ms for BS) but significantly higher when compared to the control group (410.0 ± 19.9 ms, p = 0.003). The spatial angle between the initial and the end part of the QRS was significantly higher for ARVD group than for BS group (62.1 ± 28.0° versus 47.0 ± 24.8° respectively, p<0.05).The spatial angle between the beginning of the QRS and the T-wave loop was significantly larger in ARVD group when compared to BS and control groups ( 58.3 ± 43.3° versus 28.4 ±14.7°and 23.0 ± 13.2° respectively, p < 0.05). Tpeak-Tend (Tpe) interval was significantly prolonged in patients with BS versus ARVD patients or control subjects (116.1 ± 14.4 ms versus 106.4 ± 14.4 and 96.6 ± 14.2 ms, p < 0.001).
Conclusions: In BS and ARVD the prolongation of ventricular depolarization is underlied by 2 different mechanisms. 3 D-ECG analysis suggests that transmural dispersion of repolarization is the hallmark of BS whereas abnormal spatial propagation of depolarization and repolarization wavefronts prevails in ARVD.