title: Prolonged QRS duration in lead V2 and risk of life-threatening ventricular Arrhythmia in patients with Brugada syndrome.
abstract: Brugada syndrome is an inherited disorder that predisposes some patients to sudden cardiac death. It is not well established which Brugada syndrome patients are at risk of life-threatening arrhythmias. We investigated whether standard 12-lead electrocardiograms (ECG) can identify such patients. The subjects were 35 men with Brugada syndrome (mean age, 50.1 ± 12.4 years). Documented ventricular fibrillation or aborted sudden cardiac arrests were judged to be related to the Brugada syndrome. Ten patients (mean age, 49.6 ± 14.9 years) were symptomatic, and 25 (mean age, 50.3 ± 11.5 years) were asymptomatic. We determined the PR interval, QRS duration, and QT interval from baseline 12-lead ECG leads II and V2 as well as the J point elevation amplitude of lead V2. The QRS interval was measured from QRS onset to the J point in leads II and V2. The only significant difference between the symptomatic and asymptomatic patients was the QRS duration measured from lead V2. The mean QRS interval was 129.0 ± 23.9 ms in symptomatic patients versus 108.3 ± 15.9 ms in asymptomatic patients (P = 0.012). A QRS interval in lead V2 ≥ 120 ms was found to be a possible predictor of a life-threatening ventricular arrhythmia and/or syncope (P = 0.012). Prolonged QRS duration as measured on a standard 12-lead ECG is associated with ventricular arrhythmia and could serve as a simple noninvasive marker of vulnerability to life-threatening cardiac events in patients with Brugada syndrome.
authors.affiliation: Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Kimie
authors.initials: K
authors.lastname: Ohkubo
authors.forename: Ichiro
authors.initials: I
authors.lastname: Watanabe
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Okumura
authors.forename: Sonoko
authors.initials: S
authors.lastname: Ashino
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kofune
authors.forename: Koichi
authors.initials: K
authors.lastname: Nagashima
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kofune
authors.forename: Toshiko
authors.initials: T
authors.lastname: Nakai
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kunimoto
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kasamaki
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirayama
mesh_terms: D000328:Adult; D000368:Aged; D053840:Brugada Syndrome / Q000150:complications* / Q000175:diagnosis*; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D004562:Electrocardiography; D006329:Heart Conduction System; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014693:Ventricular Fibrillation / Q000209:etiology*