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Increased Intraatrial Conduction Abnormality Assessed by P‐Wave Signal‐Averaged Electrocardiogram in Patients with Brugada Syndrome
Author(s) -
FURUKAWA YOSHIO,
YAMADA TAKAHISA,
OKUYAMA YUJI,
MORITA TAKASHI,
TANAKA KOJI,
IWASAKI YUSUKE,
UEDA HIROMICHI,
OKADA TAKESHI,
KAWASAKI MASATO,
KURAMOTO YUKI,
FUKUNAMI MASATAKE
Publication year - 2011
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2011.03122.x
Subject(s) - medicine , brugada syndrome , cardiology , atrial fibrillation , electrocardiography , j wave , electrical conduction system of the heart , qrs complex
Background: Atrial fibrillation (AF) is observed in patients with Brugada syndrome (BS), especially those showing coved‐type electrocardiogram (ECG) pattern. Using P‐wave signal‐averaged ECG (P‐SAE), we investigated whether increased intraatrial conduction abnormality contributed to AF generation in BS patients.Methods: Twenty BS patients and 20 age‐ and gender‐matched healthy controls were enrolled. At the P‐SAE recording, 12 of the 20 BS patients showed coved‐type (C‐BS) and eight showed saddleback‐type (S‐BS). The total duration (Ad) and root mean square voltage for the terminal 20 ms (LP 20 ) of the filtered P wave were measured. P‐wave dispersion (P‐disp) was defined as the difference between the maximum and minimum, measured from 16 precordial recording sites.Results: BS patients had a significantly longer Ad (128.2 ± 7.6 vs 116.3 ± 8.2 ms, P < 0.0001), lower LP 20 (2.6 ± 0.9 vs 3.4 ± 0.8 μV, P < 0.01), and greater P‐disp (15.5 ± 7.0 vs 7.4 ± 3.2 ms, P < 0.0001) than the controls. C‐BS patients had significantly longer Ad (131.0 ± 7.2 vs 124.1 ± 6.8 ms, P < 0.05) and lower LP 20 (2.2 ± 0.6 vs 3.2 ± 1.0 μV, P < 0.05) than S‐BS patients. All C‐BS patients and only three S‐BS patients had atrial late potential (100% vs 38%, P < 0.01).Conclusion: Intraatrial conduction delay and its heterogeneity may exist in BS patients, especially those showing coved‐type ECG patterns. These atrial electrical abnormalities could be a substrate for atrial reentrant tachycardia such as AF. (PACE 2011; 34:1138–1146)