“…Apart from a few exceptions, the studied population has been already described in our previously reports [16,17]. Hundred seventeen patient were included in the FINGER (France, Italy, Netherlands, Germany) Brugada syndrome registry [2], 36 of them and 30 additional patients being also included in a previous study [18].…”
The Tpe interval in the precordial leads is highly related to malignant ventricular arrhythmias in this large cohort of patients with BS. This simple electrocardiographic parameter could be used to refine risk stratification.
“…Apart from a few exceptions, the studied population has been already described in our previously reports [16,17]. Hundred seventeen patient were included in the FINGER (France, Italy, Netherlands, Germany) Brugada syndrome registry [2], 36 of them and 30 additional patients being also included in a previous study [18].…”
The Tpe interval in the precordial leads is highly related to malignant ventricular arrhythmias in this large cohort of patients with BS. This simple electrocardiographic parameter could be used to refine risk stratification.
“…The presence of a type I Brugada pattern in infero-lateral leads was found in $10% of Brugada patients and has been associated with increased risk of cardiac events [59,60]. Similarly, the presence of J waves in infero-lateral leads was found in 11-15% of BrS patients [5,61] and has also been described as a risk marker for cardiac events and arrhythmic storms in several studies [62][63][64].…”
Most asymptomatic BrS patients are at low risk of cardiac events. The presence of new risk markers in this population may prompt consideration of primary prevention measures; however, data supporting this approach are still limited.
“…: 44 prolonged QRS duration 31, 45–47 and early repolarization pattern in the inferolateral leads. 30, 31, 47, 48 …”
Section: Risk Stratification In Brsmentioning
confidence: 99%
“…Commonly accepted risk factors include Spontaneous Type 1 BrS ECG, history of cardiac events or syncope likely due to VT/VF, 8, 33–35 aborted sudden cardiac death, documented VT/VF, nocturnal agonal respiration, late potentials on epicardial bipolar electrogram or SAECG, 36–42 T wave amplitude variability, 37 short ventricular refractory period (< 200 ms), 34 fragmented QRS, 34, 43 and ST segment elevation in the peripheral leads, particularly aVR. 44 …”
Introduction
Brugada syndrome (BrS) is an inherited cardiac arrhythmia syndrome characterized by prominent J waves appearing as distinct coved type ST segment elevation in the right precordial leads of the ECG. It is associated with a high risk for sudden cardiac death.
Areas Covered
We discuss 1) ECG manifestations of BrS which can be unmasked or aggravated by sodium channel blockers, febrile states, vagotonic agents, as well as tricyclic and tetracyclic antidepressants; 2) Genetic basis of BrS; 3) Ionic and cellular mechanisms underlying BrS; 4) Therapy involving devices including an implantable cardioverter defibrillator (ICD); 5) Therapy involving radiofrequency ablation; and 6) Therapy involving pharmacological therapy which is aimed at producing an inward shift in the balance of the currents active during phase 1 of the right ventricular action potential either by boosting calcium channel current (isoproterenol, cilostazol and milrinone) or by inhibition of transient outward current Ito (quinidine, bepridil and the Chinese herb extract Wenxin Keli).
Expert Opinion
This review provides an overview of the clinical and molecular aspects of BrS with a focus on approaches to therapy. Available data suggest that agents capable of inhibiting the transient outward current Ito can exert an ameliorative effect regardless of the underlying cause.
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