Abstract 14981: Prognostic Significance Of Early Repolarization In Inferolateral Leads In Brugada Patients With Documented Ventricular Fibrillation
Background: Prognostic significance of the early repolarization (ER) in inferolateral leads in patients with Brugada syndrome was not known well. The purpose of this study was to investigate the prevalence and the prognostic significance of the ER in Brugada patients with documented VF and implanted ICD for second prevention.
Methods: Forty nine Brugada patients (pts) with documented VF and ICD implantation (46 males, 22-72, 46±13years) from two Japanese centers were studied. We collected 10 different 12-leads electrocardiograms (ECG) in each patient for evaluating the presence and the frequency of ER. ER was defined as an elevation of the J-point (QRS-ST junction) ≥ 0.1 mV above the baseline level in at least two inferolateral leads. We categorized these patients into three groups according to frequency of ER in inferolateral leads and compared the prognosis and the recurrence of VF in these three groups.
Results: ER was observed persistently (in all ECGs) in 15 patients (P group), intermittently (in some ECGs) in 16 patients (I group), and not observed in 18 patients (N group). During follow up period (7.7±3.8 years), recurrence of VF was documented in all 15 patients (100%) with P group, and less in 12 patients with I group (75%, p=0.11, log rank test) and in 8 patients with N group (44%, p=0.0001, log rank test). Moreover, episodes of VF per year were more frequent in P group and I group than in N group (1.20±1.04, 0.91±0.98 vs.0.31±0.65, p=0.0016, 0.0221).
Conclusions: The prevalence of ER in inferolateral leads was high (31/49 63.2%) in Brugada patients with documented VF. In Brugada patients with documented VF, persistent and intermittent ER in inferolateral leads is associated with a worse outcome than those without ER. The probability of recurrent VF episodes varies with the temporal stability of ER in these patients.
- © 2011 by American Heart Association, Inc.