Abstract 16522: Time-Domain T-Wave Alternans in Lead V2 is Useful for Predicting Ventricular Arrhythmias in Patients With Brugada Syndrome
Introduction: Previous studies have demonstrated that time-domain T-wave alternans (TWA) is an indicator of cardiac electrical vulnerability to ventricular arrhythmias and is useful for stratifying risk of sudden cardiac death. We evaluated the utility of the time-domain TWA for predicting ventricular fibrillation (VF) in patients with Brugada syndrome (BrS).
Methods and Results: We enrolled 42 patients with BrS (41 males; mean age, 46 ± 16 years) and investigated the relationships between episodes of VF and several clinical, electrocardiographic, and electrophysiological parameters. We analyzed the time-domain TWA by the modified moving average method during 24-h Holter recordings using the MARS system in leads V5 (CM5) and V2 (NASA) and considered the result positive when maximum voltage was ≥60 μV. During 45.2 ± 37.9 months of follow-up, five of the 42 patients with BrS (12%) experienced VF events terminated by implanted cardioverter defibrillator shocks. The percentage of positive TWA was significantly higher in patients with a VF history than those without (V5, 50% vs. 13%, p = 0.018; V2, 63% vs. 3%, p < 0.0001). The incidence of VF events was significantly higher in patients with a positive TWA in lead V2 than in those without (p = 0.0026), whereas it was similar between patients with and without positive TWA in lead V5. Logistic regression analysis revealed that positive TWA in lead V2 was an independent predictor of VF events.
Conclusion: The time-domain TWA in lead V2 is thought to be a useful parameter for predicting life-threatening events in patients with BrS.
- © 2013 by American Heart Association, Inc.