Clarifying the arrhythmogenic substrate for Brugada syndrome.
The right ventricular outflow tract (RVOT) is considered the arrhythmogenic region that gives rise to Brugada syndrome. To obtain a better understanding of this substrate, we performed electroanatomic mapping of the right ventricle (RV) in patients with Brugada syndrome. The RV was mapped electroanatomically with the CARTO system in 11 patients with asymptomatic Brugada syndrome but in whom ventricular fibrillation was induced by programmed ventricular stimulation, and in 5 control patients. The low voltage zone area (< 1.5 mV) was larger (16.1% versus 7.8%, P < 0.01) and the bipolar electrogram duration was greater (81.6 ± 7.8 ms versus 53.4 ± 5.6 ms, P < 0.01) in the patients with Brugada syndrome versus the control patients; the bipolar electrogram duration was greater in the septal portion and free wall of the RVOT. Our data suggest that regional endocardial conduction slowing based on structural abnormalities exists at the RVOT in Brugada syndrome.
Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
Masayoshi
M
Kofune
Ichiro
I
Watanabe
Kimie
K
Ohkubo
Sonoko
S
Ashino
Yasuo
Y
Okumura
Koichi
K
Nagashima
Hiroaki
H
Mano
Toshiko
T
Nakai
Yuji
Y
Kasamaki
Atsushi
A
Hirayama
D000328:Adult; D000368:Aged; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000175:diagnosis / Q000503:physiopathology; D053840:Brugada Syndrome / Q000175:diagnosis* / Q000503:physiopathology*; D002304:Cardiac Pacing, Artificial; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000295:instrumentation*; D022062:Electrophysiologic Techniques, Cardiac / Q000295:instrumentation*; D004699:Endocardium / Q000503:physiopathology*; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation*; D021621:Imaging, Three-Dimensional / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation*; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000503:physiopathology; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000503:physiopathology