Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Risk Determinants in Individuals With a Spontaneous Type 1 Brugada ECG
Akashi MiyamotoHideki HayashiTakeru MakiyamaTomohide YoshinoYuka MizusawaYoshihisa SugimotoMakoto ItoJoel Q XueYoshitaka MurakamiMinoru Horie
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JOURNALS FREE ACCESS Advance online publication
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Article ID: CJ-10-0903

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Abstract

Background: Spontaneous coved ST-segment elevation ≥2mm followed by a negative T-wave in the right precordial leads (type 1 Brugada ECG) is diagnostic of Brugada syndrome (BS), but there is a false-positive rate. Methods and Results: Computer-processed analysis of a 12-lead ECG database containing 49,286 females and 52,779 males was performed to select patients with a spontaneous type 1 Brugada ECG for an examination of the association of this ECG characteristic with long-term prognosis. There were 185 patients with a spontaneous type 1 Brugada ECG and of these, 16 (15 males; mean age, 46.7±14.0 years) were diagnosed with BS and 15 patients (all males; mean age, 50.1±13.4 years) were undiagnosed. The PQ interval was significantly longer in the diagnosed patients than in the undiagnosed patients (187.4±28.3ms vs. 161.2±21.5ms; P=0.0073). The T-wave in lead V1 was more negative in the diagnosed patients than in the undiagnosed patients (-170.2±174.6μV vs. -43.2±122.3μV, P=0.027). Multivariate analysis revealed that a PQ interval ≥170ms and T-wave amplitude <105μV in lead V1 were independent risk stratifiers of life-threatening events. Survival analysis (mean follow-up, 78.6±81.8 months) showed that the PQ interval and a negative T-wave in lead V1 were significantly associated with poor prognosis. Conclusions: Analysis of a standard 12-lead ECG can stratify the prognosis of patients with a spontaneous type 1 Brugada ECG.

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© 2011 THE JAPANESE CIRCULATION SOCIETY
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