Open AccessPrevalence and characteristics of the Brugada electrocardiogram pattern in patients with arrhythmogenic right ventricular cardiomyopathy
Author(s) -
Ueda Nobuhiko,
Nagase Satoshi,
Kataoka Naoya,
Nakajima Kenzaburo,
Kamakura Tsukasa,
Wada Mitsuru,
Yamagata Kenichiro,
Ishibashi Kohei,
Inoue Yuko,
Miyamoto Koji,
Noda Takashi,
Aiba Takeshi,
Izumi Chisato,
Noguchi Teruo,
Ohno Seiko,
Kusano Kengo
Publication year - 2021
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1002/joa3.12628
Subject(s) - medicine , brugada syndrome , interquartile range , cardiology , sudden cardiac death , qrs complex , j wave , implantable cardioverter defibrillator , ventricular fibrillation , cardiomyopathy , electrocardiography , heart failure
Background Despite distinct pathophysiology, arrhythmogenic right ventricular cardiomyopathy (ARVC) and Brugada syndrome (BrS) exhibit overlapping phenotypes. We investigated the prevalence and characteristics of the Brugada electrocardiogram (ECG) pattern in ARVC patients. Methods A total of 114 ARVC patients fulfilling the revised Task Force Criteria were enrolled. The Brugada ECG pattern was evaluated according to the consensus report on right precordial leads, and 1141 ECGs (median, 1; interquartile range, 1‐16 ECGs/patient) were analyzed. Results Five patients (4%) showed a Brugada ECG pattern, which disappeared in four patients with ECGs recorded more than 2 years afterward. ARVC patients with the Brugada ECG pattern had a longer PQ interval (220 ± 62 ms vs 180 ± 35 ms, P = .02) and longer QRS duration (138 ± 25 ms vs 102 ± 23 ms, P < .001) than patients without the pattern. During follow‐up (median, 11.4; interquartile range, 5.5‐17.1 years), 19 ARVC patients experienced cardiac death and 29 experienced heart failure (HF) hospitalization. Kaplan‐Meier analysis determined that the Brugada ECG pattern increased the risk of cardiac death and HF hospitalization (log‐rank; P < .001, P < .001 respectively). The mean J‐point and S‐wave amplitudes of the Brugada ECG pattern were 0.29 ± 0.05 mV and 0.34 ± 0.21 mV, respectively, which were significantly lower than those of 26 age‐matched BrS patients with a previous ventricular fibrillation episode (0.66 ± 0.33 mV, P < .001 and 0.67 ± 0.39 mV, P = .02 respectively). Conclusion The Brugada ECG pattern was infrequently encountered, was transient in ARVC patients, and was associated with a longer PQ interval, longer QRS duration, and cardiac events.