Predictive impact of the inducibility of ventricular fibrillation in patients with Brugada-type ECG.
The natural history of asymptomatic individuals with a Brugada-type electrocardiogram (ECG) is still controversial. In this study, we evaluated ventricular fibrillation (VF) inducibility in Brugada-type ECG patients and compared it with other risk factors to clarify the significance of these data on their prognosis. The study population consisted of 38 patients who presented with a typical ST-segment elevation in the precordial leads and underwent an electrophysiological study (EPS). The patients were divided into 3 groups; group A: patients with spontaneous ventricular fibrillation (VF) (n = 5), group B: patients without clinical VF but with inducible VF in EPS (n = 16), and group C: patients with neither clinical nor inducible VF (n = 17). The clinical features, diagnostic results, and prognosis were compared among these groups. During the follow-up period of 26 +/- 19 months, 2/5 (group A), 1/16 (group B), and 0/17 (group C) patients suffered fatal arrhythmic events. None of the clinical features showed any significant difference, although the incidence of positive results in a drug challenge test was higher in groups A and B than in group C (P < 0.05). On the other hand, VF inducibility was higher in patients with positive results in the drug challenge test than in patients with negative results (59% versus 13%; P < 0.05). No VF episodes were observed in patients without VF induction, although one was observed in 1 of 16 patients with VF induction in asymptomatic Brugada syndrome. The drug challenge test appears to be useful for predicting VF inducibility even though it is a noninvasive test.
Imaki
Ryuta
R
Department of Angio-Cardiology, Kitasato University School of Medicine, Japan.
Niwano
Shinichi
S
Fukaya
Hidehira
H
Sasaki
Sae
S
Yuge
Masaru
M
Hirasawa
Shoji
S
Sato
Daisuke
D
Sasaki
Takeshi
T
Moriguchi
Masahiko
M
Izumi
Tohru
T
D019797:3-Iodobenzylguanidine; D000109:Acetylcholine; D002037:Bundle-Branch Block / Q000150:complications* / Q000175:diagnosis; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000503:physiopathology; D004562:Electrocardiography; D004594:Electrophysiology; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007457:Iodine Radioisotopes; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013577:Syndrome; D014693:Ventricular Fibrillation / Q000175:diagnosis* / Q000209:etiology
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine; D000109:Acetylcholine