title: A spontaneous Type 1 electrocardiogram pattern in lead V2 is an independent predictor of ventricular fibrillation in Brugada syndrome.
abstract: OBJECTIVE
  Risk stratification for Brugada syndrome remains controversial. We investigated the relationships between episodes of ventricular fibrillation (VF) and various clinical, electrocardiographic, electrophysiologic, and genetic parameters both retrospectively and prospectively.
  
  
  RESULTS
  Fifty-two patients with Brugada syndrome (49 men, average age 42 +/- 3 years) were studied. In the Brugada patients with a VF history, the frequency of a spontaneous Type 1 electrocardiogram (ECG) pattern in lead V2 was significantly higher and the STJ amplitude in the V1 and V2 leads was also higher than in those without a VF history. Multivariate analyses revealed that the spontaneous Type 1 ECG pattern in lead V2 (but not lead V1) was the only independent predictor of a VF history. During a mean follow-up period of 39 +/- 4 months, 38.8% of the patients with a VF history and 2.9% of those without experienced an appropriate implantable cardioverter-defibrillation owing to VF. A multivariate analysis using a Cox's proportional hazard model showed that a VF history and spontaneous Type 1 ECG pattern in lead V2 were independent predictors of subsequent VF events.
  
  
  CONCLUSIONS
  A spontaneous Type 1 Brugada ECG pattern in lead V2 (but not lead V1) was both a prospective and retrospective independent predictor of VF episodes in Brugada syndrome.
authors.affiliation: Department of Cardiovascular Medicine, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. nakanoy@hiroshima-u.ac.jp
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Nakano
authors.forename: Wataru
authors.initials: W
authors.lastname: Shimizu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ogi
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Suenari
authors.forename: Noboru
authors.initials: N
authors.lastname: Oda
authors.forename: Yuko
authors.initials: Y
authors.lastname: Makita
authors.forename: Kenta
authors.initials: K
authors.lastname: Kajihara
authors.forename: Yukoh
authors.initials: Y
authors.lastname: Hirai
authors.forename: Akinori
authors.initials: A
authors.lastname: Sairaku
authors.forename: Takehito
authors.initials: T
authors.lastname: Tokuyama
authors.forename: Yukiji
authors.initials: Y
authors.lastname: Tonouchi
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Ueda
authors.forename: Taijiro
authors.initials: T
authors.lastname: Sueda
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
authors.forename: Yasuki
authors.initials: Y
authors.lastname: Kihara
mesh_terms: D000328:Adult; D053840:Brugada Syndrome / Q000175:diagnosis* / Q000453:epidemiology* / Q000235:genetics; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000517:prevention & control; D017147:Defibrillators, Implantable; D018572:Disease-Free Survival; D004562:Electrocardiography; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009124:Muscle Proteins / Q000235:genetics; D062554:NAV1.5 Voltage-Gated Sodium Channel; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D015222:Sodium Channels / Q000235:genetics; D014693:Ventricular Fibrillation / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy
chemical_list: D009124:Muscle Proteins; D062554:NAV1.5 Voltage-Gated Sodium Channel; C568320:SCN5A protein, human; D015222:Sodium Channels