Premium
Spatiotemporal Characteristics of QRS Complexes Enable the Diagnosis of Brugada Syndrome Regardless of the Appearance of a Type 1 ECG
Author(s) -
GUILLEM MARIA S.,
CLIMENT ANDREU M.,
MILLET JOSÉ,
BERNE PAOLA,
RAMOS RAFAEL,
BRUGADA JOSEP,
BRUGADA RAMON
Publication year - 2016
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.12937
Subject(s) - brugada syndrome , medicine , cardiology , qrs complex , bundle branch block , cutoff , receiver operating characteristic , right bundle branch block , electrocardiography , physics , quantum mechanics
QRS Spatiotemporal Characteristics in Brugada Syndrome Introduction The diagnosis of Brugada syndrome based on the ECG is hampered by the dynamic nature of its ECG manifestations. Brugada syndrome patients are only 25% likely to present a type 1 ECG. The objective of this study is to provide an ECG diagnostic criterion for Brugada syndrome patients that can be applied consistently even in the absence of a type 1 ECG. Methods and Results We recorded 67‐lead body surface potential maps from 94 Brugada syndrome patients and 82 controls (including right bundle branch block patients and healthy individuals). The spatial propagation direction during the last r’ wave and the slope at the end of the QRS complex were measured and compared between patients groups. Receiver‐operating characteristic curves were constructed for half of the database to identify optimal cutoff values; sensitivity and specificity for these cutoff values were measured in the other half of the database. A spontaneous type 1 ECG was present in only 30% of BrS patients. An orientation in the sagittal plane < 101º during the last r’ wave and a descending slope < 9.65 mV/s enables the diagnosis of the syndrome with a sensitivity of 69% and a specificity of 97% in non‐type 1 Brugada syndrome patients. Conclusion Spatiotemporal characteristics of surface ECG recordings can enable a robust identification of BrS even without the presence of a type 1 ECG.