aVR sign as a risk factor for life-threatening arrhythmic events in patients with Brugada syndrome.
BACKGROUND
Risk stratification in Brugada syndrome (BS) is controversial, especially in asymptomatic individuals.


OBJECTIVE
The aim of this study was to evaluate the significance of lead aVR in patients with BS.


METHODS
Twenty-four patients with the electrocardiogram pattern of BS (24 male, mean age 32.1 +/- 13.6 years) and 24 healthy age- and gender-matched controls were studied.


RESULTS
Thirteen patients were symptomatic. The R-wave amplitude or R/q ratio in lead aVR was significantly greater in patients experiencing a recurrence compared with those who did not. The aVR sign was defined as R wave >/= 0.3 mV or R/q >/= 0.75 in lead aVR. Most of the recurrences (78%) were in patients with present aVR sign; 84% of BS patients with present aVR sign had events during follow-up. In contrast, only 27% of BS patients with absent aVR sign had events during follow-up.


CONCLUSIONS
Our study shows significant correlation between a prominent R wave in lead aVR (aVR sign) and risk for development of arrhythmic events in BS. In the presence of BS, prominent R wave in lead aVR may reflect more right ventricular conduction delay and subsequently more electrical heterogeneity, which in turn is responsible for a higher risk of arrhythmia.
Cardiology Department, Shiraz University of Medical Sciences, Shiraz, Iran.
Mohamad Ali
MA
Babai Bigi
Amir
A
Aslani
Shahab
S
Shahrzad
D000328:Adult; D053840:Brugada Syndrome / Q000175:diagnosis*; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors