New electrocardiographic criteria for discriminating between Brugada types 2 and 3 patterns and incomplete right bundle branch block.


Autoria(s): Chevallier S.; Forclaz A.; Tenkorang J.; Ahmad Y.; Faouzi M.; Graf D.; Schlaepfer J.; Pruvot E.
Data(s)

2011

Resumo

OBJECTIVES: The aim of this study was to evaluate new electrocardiographic (ECG) criteria for discriminating between incomplete right bundle branch block (RBBB) and the Brugada types 2 and 3 ECG patterns. BACKGROUND: Brugada syndrome can manifest as either type 2 or type 3 pattern. The latter should be distinguished from incomplete RBBB, present in 3% of the population. METHODS: Thirty-eight patients with either type 2 or type 3 Brugada pattern that were referred for an antiarrhythmic drug challenge (AAD) were included. Before AAD, 2 angles were measured from ECG leads V(1) and/or V(2) showing incomplete RBBB: 1) α, the angle between a vertical line and the downslope of the r'-wave, and 2) β, the angle between the upslope of the S-wave and the downslope of the r'-wave. Baseline angle values, alone or combined with QRS duration, were compared between patients with negative and positive results on AAD. Receiver-operating characteristic curves were constructed to identify optimal discriminative cutoff values. RESULTS: The mean β angle was significantly smaller in the 14 patients with negative results on AAD compared to the 24 patients with positive results on AAD (36 ± 20° vs. 62 ± 20°, p < 0.01). Its optimal cutoff value was 58°, which yielded a positive predictive value of 73% and a negative predictive value of 87% for conversion to type 1 pattern on AAD; α was slightly less sensitive and specific compared with β. When the angles were combined with QRS duration, it tended to improve discrimination. CONCLUSIONS: In patients with suspected Brugada syndrome, simple ECG criteria can enable discrimination between incomplete RBBB and types 2 and 3 Brugada patterns.

Identificador

http://serval.unil.ch/?id=serval:BIB_4A316CFDC50E

isbn:1558-3597 (Electronic)

pmid:22093505

doi:10.1016/j.jacc.2011.08.039

isiid:000297149900006

Idioma(s)

en

Direitos

info:eu-repo/semantics/openAccess

Fonte

Journal of the American College of Cardiology, vol. 58, no. 22, pp. 2290-2298

Palavras-Chave #Adult; Ajmaline/diagnostic use; Anti-Arrhythmia Agents/diagnostic use; Brugada Syndrome/classification; Brugada Syndrome/diagnosis; Bundle-Branch Block/diagnosis; Electrocardiography/methods; Female; Humans; Male; Predictive Value of Tests; Prospective Studies; ROC Curve; Reproducibility of Results
Tipo

info:eu-repo/semantics/article

article