title: Relationships between depolarization abnormality and repolarization abnormality in patients with Brugada syndrome: using body surface signal-averaged electrocardiography and body surface maps.
abstract: BACKGROUND
  Repolarization and depolarization abnormalities have been reported to be related to Brugada syndrome.
  
  
  RESULTS
  We evaluated the relationships between repolarization abnormality and depolarization abnormality using 48-lead unipolar signal-averaged electrocardiograms and 87-lead unipolar body surface maps in 15 patients with Brugada-type ECGs. Data were compared with those from healthy control subjects (n = 5) and within subgroups of Brugada syndrome with (n = 8) and without (n = 7) ventricular arrhythmias (VA) induced by programmed electrical stimulation (PES). Eighty-seven-lead body surface maps were recorded, and potential maps were constructed to evaluate elevation of the ST segment 20 ms after the J point. Forty-eight-lead signal-averaged ECGs were recorded, and isochronal maps of duration of the delayed potential (dDP) were constructed to evaluate the dDP in each lead. Potential maps showed that patients with Brugada-type ECG, especially those with VA induced by programmed electrical stimulation, had greater elevation of the ST segment in the right ventricular outflow tract, especially at E5. Isochronal maps of dDP in the Brugada-type ECG group showed that maximum dDP was located at E5 and that the area with long dDP was larger than that in the control subjects. The dDPs at E7, E5, F7, and F5 in the VA-inducible group were significantly longer than those in the VA-noninducible group. These results showed that the location of greater elevation in the ST segment coincided with the location of longer dDP.
  
  
  CONCLUSIONS
  Repolarization abnormality and depolarization abnormality in the walls of both ventricles, especially in the right ventricular outflow tract, are related to the VA of Brugada syndrome.
authors.affiliation: Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan. kenichi@cc.okayama-u.ac.jp
authors.forename: Kenichi
authors.initials: K
authors.lastname: Hisamatsu
authors.forename: Kengo Fukushima
authors.initials: KF
authors.lastname: Kusano
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Morita
authors.forename: Shiho
authors.initials: S
authors.lastname: Takenaka
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nagase
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Nakamura
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Emori
authors.forename: Hiromi
authors.initials: H
authors.lastname: Matsubara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mikouchi
authors.forename: Yoshitomo
authors.initials: Y
authors.lastname: Nishizaki
authors.forename: Tohru
authors.initials: T
authors.lastname: Ohe
mesh_terms: D000328:Adult; D018780:Body Surface Potential Mapping / Q000379:methods*; D002037:Bundle-Branch Block / Q000175:diagnosis* / Q000503:physiopathology*; D004558:Electric Stimulation; D004562:Electrocardiography / Q000379:methods; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013223:Statistics as Topic; D013577:Syndrome; D014693:Ventricular Fibrillation / Q000175:diagnosis* / Q000503:physiopathology*