Characteristic features of QRST integral mapping in patients with high risk Brugada syndrome.
BACKGROUND
The characteristic features of QRST integral mapping in the Brugada-type resting ECG of patients at a high risk for life-threatening ventricular arrhythmias were examined.


RESULTS
QRST integral mapping was performed in 11 Brugada-type ECG patients with histories of aborted sudden death, spontaneous ventricular tachycardia and fibrillation (VT/VF) or programmed electric stimulation-inducible VT/VF (high risk group); 13 Brugada-type ECG patients without a history of such events (low risk group); and 21 age-matched healthy controls. Individual QRST isointegral maps revealed the minimum integral in the mid-to-right upper chest in 100% and 85% of the control and low risk groups, respectively, whereas this integral was 64% in the upper right back of the high risk group (p<0.05). On the QRST integral departure maps, the abnormal positive departure area (integral value>or=+2 standard deviation) was located in the mid-to-right upper chest in 82% and 8% of the high and low risk groups, respectively (p<0.05). During the follow-up period, sudden death or VF occurred in 4 of 6 high risk patients with both the abnormal findings.


CONCLUSIONS
The abnormal positive departure area in the mid-to-right upper chest and the minimum QRST integral in the right upper back were distinct hallmarks for screening patients with the high risk Brugada-type ECG.
Kanahara
Masaaki
M
Department of Laboratory Medicine, Kurume University Hospital, Japan.
Kai
Hisashi
H
Toyomasu
Koji
K
Yoshida
Teruhisa
T
Hiraki
Tatsuro
T
Sagawa
Kimitaka
K
Imaizumi
Tsutomu
T
D000328:Adult; D000368:Aged; D053840:Brugada Syndrome / Q000175:diagnosis* / Q000503:physiopathology*; D016022:Case-Control Studies; D004558:Electric Stimulation; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017180:Tachycardia, Ventricular / Q000503:physiopathology; D014693:Ventricular Fibrillation / Q000503:physiopathology