title: Prevalence and Clinical Impact of Early Repolarization Pattern and QRS-Fragmentation in High-Risk Patients With Brugada Syndrome.
abstract: BACKGROUND
  The phenotypic heterogeneity of Brugada syndrome (BrS) can lead some patients to show an additional inferolateral early repolarization pattern (ERP), or fragmented QRS (f-QRS). The aim of the study was to investigate the prevalence and clinical impact of f-QRS, ERP or combined f-QRS/ERP in high-risk patients with BrS.
  
  
  RESULTS
  Patients with spontaneous or drug-induced BrS and an indication to receive an implantable cardioverter-defibrillator (ICD) were considered eligible for this study. From 1992 to 2012, a total of 176 consecutive patients with BrS underwent ICD implantation. Among them, 48 subjects (27.3%) presented with additional depolarization and/or repolarization abnormalities. f-QRS was found in 29 (16.5%), ERP in 15 (8.5%), and combined f-QRS/ERP in 4 patients (2.3%). After a mean follow-up of 95.2±51.9 months, spontaneous sustained ventricular arrhythmias were documented in 8 patients (16.7%). No significant difference was found in the rate of appropriate shocks between patients presenting with f-QRS or ERP and those without abnormalities. Patients with both f-QRS and ERP had a significantly higher rate of appropriate shocks (HR: 4.1; 95% CI: 1.1-19.7; P=0.04).
  
  
  CONCLUSIONS
  Fragmented QRS and ERP are common ECG findings in high-risk BrS patients, occurring in up to 27% of cases. When combined, f-QRS and ERP confer a higher risk of appropriate ICD interventions during a very long-term follow-up. (Circ J 2016; 80: 2109-2116).
authors: Heart Rhythm Management Centre, UZ Brussel-VUB.
authors: Giulio
authors: G
authors: Conte
authors: Carlo
authors: C
authors: de Asmundis
authors: Juan
authors: J
authors: Sieira
authors: Giuseppe
authors: G
authors: Ciconte
authors: Giacomo
authors: G
authors: Di Giovanni
authors: Gian-Battista
authors: GB
authors: Chierchia
authors: Ruben
authors: R
authors: Casado-Arroyo
authors: Giannis
authors: G
authors: Baltogiannis
authors: Erwin
authors: E
authors: Ströker
authors: Ghazala
authors: G
authors: Irfan
authors: Gudrun
authors: G
authors: Pappaert
authors: Angelo
authors: A
authors: Auricchio
authors: Pedro
authors: P
authors: Brugada
mesh_terms: D000328:Adult; D053840:Brugada Syndrome / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors