Journal Article

Comparison of conduction delay in the right ventricular outflow tract between Brugada syndrome and right ventricular cardiomyopathy: investigation of signal average ECG in the precordial leads

Hiroshi Furushima, Masaomi Chinushi, Kazuki Okamura, Kenichi Iijima, Satoru Komura, Yasutaka Tanabe, Shinsuke Okada, Daisuke Izumi and Yoshifusa Aizawa

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 9, issue 10, pages 951-956
Published in print October 2007 | ISSN: 1099-5129
Published online July 2007 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1093/europace/eum128
Comparison of conduction delay in the right ventricular outflow tract between Brugada syndrome and right ventricular cardiomyopathy: investigation of signal average ECG in the precordial leads

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Background In both Brugada syndrome (BS) and arrhythmogenic right ventricular cardiomyopathy (ARVC), electrical abnormalities in the right ventricular outflow tract (RVOT) are important for arrhythmogenesis.

Objectives The aim of this study was to compare conduction delay in the right ventricular in BS with that in ARVC using the signal-averaged electrocardiogram.

Methods Twenty patients with BS (18 men and 2 women; 55 ± 12 years old; 9 symptomatic and 11 asymptomatic) and eight patients with ARVC (six men and two women; 53 ± 16 years old) were included. We assessed the presence of late potentials (LPs) and the filtered QRS duration (fQRSd) in V2 and V5 using a high-pass filter of 40 Hz (fQRSd:40) and 100 Hz (fQRSd:100).

Results In ARVC, there was no significant difference in fQRSd:40 between V2 and V5 (158 ± 19 vs. 145 ± 17 ms, respectively): however, in BS, fQRSd:40 in V2 was significantly longer than fQRSd:40 in V5 (147 ± 15 vs. 125 ± 10 ms, P < 0.001). In ARVC, there was no significant difference between fQRSd:40 and fQRSd:100 in V2 and V5 (158 ± 19 vs. 142 ± 23 ms and 145 ± 17 vs. 132 ± 9 ms, respectively). In contrast, in BS, fQRSd:100 was significantly shorter than fQRSd:40 in V2 (110 ± 8 ms vs. 147 ± 15, P < 0.001). The relative decrease in fQRSd:100 compared with fQRSd:40 in V2 was significantly greater in BS than in ARVC.

Conclusion The dominant prolongation of the fQRSd in the right precordial lead in BS was different from the characteristics of ARVC, which may be caused by the conduction delay due to fibro-fatty replacement in RV.

Keywords: Brugada syndrome; ARVC; Signal-averaged ECG; RV outflow tract; Delayed potential

Journal Article.  3625 words.  Illustrated.

Subjects: Cardiovascular Medicine

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