Abstract 5671: Type 1 ECG burden is Increased in Symptomatic Brugada Patients
Spontaneous type 1 ECG is considered as a risk factor for arrhythmic events in Brugada patients. We aimed to evaluate the prognosis value of an increased type 1 Brugada ECG pattern burden. 32 control subjects (16 males, mean age 50.3±21.6) and 34 Brugada patients (15 with and 19 without symptoms, 30 males, mean age 46.4±11.4) underwent a 24-hour 12-lead Holter ECG recording (Syneflash, Ela, Sorin group). Using customized software, QRS-T complexes were averaged every minute, leading to 1440 ECG waveforms over the 24 hours of the recording. The averaged waveforms were automatically measured and type 1 Brugada ECG was defined as ST elevation >0.2 mV + descending ST segment + negative T-wave polarity on leads V1, V2 and/or V3. Type 1 Brugada ECG was never observed in control subjects. Symptomatic Brugada patients displayed a type 1 Brugada ECG on lead V2 during 60±41% of the recording, while this pattern was observed in 34±37% of the recording in asymptomatic patients (post-test p<0.01). A type 1 burden during more than 80% of the recording yielded to a 53% sensitivity and 89% specificity for symptom detection in Brugada patients. Long-term 12-lead ECG recordings increase the probability of detecting spontaneous type 1 ECG pattern that is more prevalent across a 24-hour period in symptomatic patients. The evaluation of long-term type 1 ECG burden may improve risk stratification in Brugada patients.