Markers of ventricular repolarization as an additional non-invasive electrocardiography parameters for predicting ventricular tachycardia/fibrillation in patients with Brugada Syndrome – A systematic review and meta-analysis

Pranata, Raymond; Yonas, Emir; Vania, Rachel; Huang, Ian

doi:10.1016/j.ipej.2019.06.003

Cited by 6 publications

(5 citation statements)

References 27 publications

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“…This would suggest altered repolarization playing an important role in mediating ventricular arrhythmogenesis in this subgroup (31)(32)(33)(34). It is hypothesised that QTc prolongation reflects the increased dispersion in transmural ventricular repolarization, thus increase the risk of VT/VF (35)(36)(37)(38)(39)(40)(41)(42). Moreover, we found that paediatric/young patients had a higher QRS axis, in keeping with previous demonstrations of right axis deviation in younger patients but this variable was not a predictor of arrhythmic events.…”

Section: Brugada Syndrome In the Youngsupporting

confidence: 88%

Ventricular Tachyarrhythmia Risk in Paediatric/Young vs. Adult Brugada Syndrome Patients: A Territory-Wide Study

Lee¹,

Wong

et al. 2021

Front. Cardiovasc. Med.

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Introduction: Brugada syndrome (BrS) is a cardiac ion channelopathy with a higher prevalence in Asia compared to the Western populations. The present study compared the differences in clinical and electrocardiographic (ECG) presentation between paediatric/young (≤25 years old) and adult (>25 years) BrS patients.Method: This was a territory-wide retrospective cohort study of consecutive BrS patients presenting to public hospitals in Hong Kong. The primary outcome was spontaneous ventricular tachycardia/ventricular fibrillation (VT/VF).Results: The cohort consists of 550 consecutive patients (median age of initial presentation = 51 ± 23 years; female = 7.3%; follow-up period = 83 ± 80 months), divided into adult (n = 505, mean age of initial presentation = 52 ± 19 years; female = 6.7%; mean follow-up period = 83 ± 80 months) and paediatric/young subgroups (n = 45, mean age of initial presentation = 21 ± 5 years, female = 13.3%, mean follow-up period = 73 ± 83 months). The mean annual VT/VF incidence rate were 17 and 25 cases per 1,000 patient-year, respectively. Multivariate analysis showed that initial presentation of type 1 pattern (HR = 1.80, 95% CI = [1.02, 3.15], p = 0.041), initial asymptomatic presentation (HR = 0.26, 95% CI = [0.07, 0.94], p = 0.040) and increased P-wave axis (HR = 0.98, 95% CI = [0.96, 1.00], p = 0.036) were significant predictors of VT/VF for the adult subgroup. Only initial presentation of VT/VF was predictive (HR = 29.30, 95% CI = [1.75, 492.00], p = 0.019) in the paediatric/young subgroup.Conclusion: Clinical and ECG presentation of BrS vary between the paediatric/young and adult population in BrS. Risk stratification and management strategies for younger patients should take into consideration and adopt an individualised approach.

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Section: Brugada Syndrome In the Youngsupporting

confidence: 88%

Ventricular Tachyarrhythmia Risk in Paediatric/Young vs. Adult Brugada Syndrome Patients: A Territory-Wide Study

Lee¹,

Wong

et al. 2021

Front. Cardiovasc. Med.

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“…Importantly, Tp-e was found to be the most promising ECG marker together with QTc interval in predicting malignant arrhythmias among BS patients. However, there is a need to assess the cut-off for the Tp-e value, which significantly increases the risk of life-threatening arrhythmias [ 117 ]. Interestingly, when the BS typical ECG pattern was observed in precordial leads V1–V3, it was simultaneously revealed that the Tp-e interval in V1 lead was significantly higher among patients with malignant arrhythmias.…”

Section: Resultsmentioning

confidence: 99%

Tpeak‐Tend ECG Marker in Obesity and Cardiovascular Diseases: A Comprehensive Review

Dykiert,

Florek,

Kraik

et al. 2024

Scientifica

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Globally, cardiovascular diseases are still the leading cause of death. Numerous methods are used to diagnose cardiovascular pathologies; there is still a place for straightforward and noninvasive techniques, such as electrocardiogram (ECG). Depolarization and repolarization parameters, including QT interval and its derivatives, are well studied. However, the Tpeak‐Tend interval is a novel and promising ECG marker with growing evidence for its potential role in predicting malignant arrhythmias. In this review, we discuss the association between the Tpeak‐Tend interval and several cardiovascular diseases, including long QT syndrome, cardiomyopathies, heart failure, myocardial infarction, and obesity, which constitutes one of the risk factors for cardiovascular diseases.

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“…Conversely, we do not recommend the routine use of indices of ventricular repolarization for COVID-19 patients who are not otherwise at risk of QT prolongation. This recommendation was not solely based on the current findings, as there are significant methodological concerns about the usefulness of these parameters for predicting ventricular arrhythmias 26 .…”

Section: Discussionmentioning

confidence: 97%

Interatrial Block and Electrocardiographic Markers of Repolarization in Patients Hospitalized with COVID-19: Classical and Bayesian Analysis

CETIN GUVENC,

GUREN,

ENGUR

et al. 2023

MMJ

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Objective: Coronavirus disease-2019 (COVID-19) is associated with atrial fibrillation (AF) and ventricular arrhythmias. Several electrophysiological abnormalities on surface electrocardiography (ECG) are associated with AF and ventricular arrhythmias, either as markers of abnormal interatrial conduction or abnormal repolarization. The present study sought to understand whether such ECG markers are more common in patients hospitalized with COVID-19 infection during the pandemic. Methods: A total of 87 COVID-19 patients formed the study group, whereas 64 patients who were hospitalized for any reason other than COVID-19 infection served as controls. The frequency of partial and advanced interatrial block (IAB), QT and corrected QT (QTc) durations, QT dispersion (QTd), and T peak-to-end duration (Tpe) were measured from ECGs at admission. Results: Both partial and advanced IAB were more common in patients with COVID-19, although statistical significance was only observed for advanced IAB (11.5% in COVID-19 patients vs. 0.0% in controls, p=0.005). There were no differences between the groups for QTc, QTd or Tpe. On Bayesian analyses, there was strong evidence favoring an association between COVID-19 and advanced IAB (BF 10 :16), whereas there was no evidence for an association for partial IAB, QTc, QTd, or Tpe (BF 10 <1 for all). Conclusions: Patients hospitalized with COVID-19 were more likely to have advanced IAB, which may explain why AF is more frequent in these patients.

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Markers of ventricular repolarization as an additional non-invasive electrocardiography parameters for predicting ventricular tachycardia/fibrillation in patients with Brugada Syndrome – A systematic review and meta-analysis

Cited by 6 publications

References 27 publications

Ventricular Tachyarrhythmia Risk in Paediatric/Young vs. Adult Brugada Syndrome Patients: A Territory-Wide Study

Ventricular Tachyarrhythmia Risk in Paediatric/Young vs. Adult Brugada Syndrome Patients: A Territory-Wide Study

Tpeak‐Tend ECG Marker in Obesity and Cardiovascular Diseases: A Comprehensive Review

Interatrial Block and Electrocardiographic Markers of Repolarization in Patients Hospitalized with COVID-19: Classical and Bayesian Analysis

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