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A comprehensive electrocardiographic, molecular and echocardiographic study of the Brugada Syndrome: Validation of the 2013 diagnostic criteria.
Heart Rhythm 11, 1176-1183 (2014)
BACKGROUND: The debate on the diagnostic value of high intercostal spaces (ICSs) and of the number of diagnostic leads in the Brugada syndrome (BrS) has been settled by a recent expert consensus statement. OBJECTIVE: We have tested the validity of the new ECG diagnostic criteria using echocardiographic, molecular and clinical evidence in one clinical BrS study population. METHODS: We analyzed 114 BrS patients with a spontaneous or drug-induced type 1 pattern recorded in one or more right precordial leads in 4(th), 3(rd) and 2(nd) ICS. The right ventricular outflow tract (RVOT) was localized by echocardiography. All probands were screened on the SCN5A gene. RESULTS: The percentage of mutation carriers (MCs) and the event rate were similar regardless of the diagnostic ICS (4(th) vs high ICSs: MCs 23% vs 19%; event rate 22% vs 28%) and of the number of diagnostic leads (1 vs ≥ 2: MCs 20% vs 22%; event rate 22% vs 27%).The concordance between RVOT anatomical location and the diagnostic ICSs was 86%. The percentage of diagnostic ECG pattern recorded was significantly increased by the exploration of the ICSs showing RVOT at echocardiography (echo-guided vs conventional approach 100% vs 43% p<0.001). CONCLUSION: The high ICSs are not inferior to the standard 4(th) ICS for the ECG diagnosis of BrS and the interindividual variability depends on anatomical location of the RVOT as assessed by echocardiography. This approach significantly increases diagnostic sensitivity without decreasing specificity and fully supports the recently published new diagnostic criteria.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Brugada Syndrome ; Diagnostic Criteria ; Echocardiography ; Electrocardiography ; Molecular Genetics; Ventricular Outflow Tract; St-segment Elevation; Sudden Cardiac Death; Type-1 Electrocardiogram; Intercostal Space; Repolarization; Leads; Ecg; Abnormalities; Association
ISSN (print) / ISBN
1547-5271
e-ISSN
1556-3871
Journal
Heart Rhythm
Quellenangaben
Volume: 11,
Issue: 7,
Pages: 1176-1183
Publisher
Elsevier
Publishing Place
New York
Non-patent literature
Publications
Reviewing status
Peer reviewed
Institute(s)
Institute of Human Genetics (IHG)