Relation of the Brugada Phenocopy to Hyperkalemia (From the International Registry on Brugada Phenocopy)

Xu, Grace; Gottschalk, Byron H.; Anselm, Daniel D.; Benditt, David G.; Maheshwari, Ankit; Sreenivasan, Shiva; Shama, Raed Abu; Dendramis, Gregory; Barajas-Martínez, Héctor; Campal, J.M. Rubio; Aznaurov, Sam G.; Baranchuk, Adrián

doi:10.1016/j.jelectrocard.2018.10.053

Cited by 3 publications

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“…An RBBB-like pattern with ≥2 mm coved ST segment elevation in the right precordial leads constitutes the so-called type I Brugada pattern necessary for diagnosis ( S9.8.6.6 ). This pattern is dynamic and can fluctuate according to variations in autonomic tone, body temperature, diurnal influences, electrolyte levels, and drug exposure, especially drugs with sodium channel blocking properties ( S9.8.6.7 – S9.8.6.9 ). Additionally, the ECG pattern can be concealed unless V1 and V2 are recorded at the higher second and third intercostal spaces ( S9.8.6.10 , S9.8.6.11 ).…”

Section: Mapping and Ablationmentioning

confidence: 99%

2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias

et al. 2020

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Representative of the European Heart Rhythm Association (EHRA) †Representative of the American College of Cardiology (ACC) ‡Representative of the Sociedade Brasileira de Arritmias Cardíacas (SOBRAC) xRepresentative of the American Heart Association (AHA) {Representative of the Latin American Heart Rhythm Society (LAHRS) #Representative of the Asia Pacific Heart Rhythm Society (APHRS) **Representative of the Japanese Heart Rhythm Society (JHRS) † †Representative of the Pediatric and Congenital Electrophysiology Society (PACES)

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Section: Mapping and Ablationmentioning

confidence: 99%

2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias

et al. 2020

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“…Along with hyperkalemia, ischemia is one of the most common modulators of cardiac sodium channels causing transient ECG changes . In this small series, ischemia‐induced BrP more commonly occurred as a Type‐1 ECG pattern compared to Type‐2.…”

Section: Discussionmentioning

confidence: 67%

Link between Brugada phenocopy and myocardial ischemia: Results from the International Registry on Brugada Phenocopy

Gottschalk

Pérez‐Riera

et al. 2019

Pacing Clinical Electrophis

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Background Brugada phenocopies clinical entities that have indistinguishable electrocardiographic (ECG) patterns from true congenital Brugada syndrome. However, they are induced by other clinical circumstances such as myocardial ischemia. The purpose of our study was to examine the clinical features and pathogenesis of ischemia‐induced Brugada phenocopy (BrP). Methods Data from 17 cases of ischemia‐induced BrP were collected from the International Registry (http://www.brugadaphenocopy.com). Data were extracted from these publications and authors were contacted to provide further insight into each case. Results Of the patients included in this study, 71% were male. Mean age was 59 ± 11 years (range: 38–76). Type‐1 Brugada ECG pattern occurred in 15/17 (88%) of the cases, while a type‐2 Brugada ECG pattern was observed in the other 2/17 (12%). In all cases, the Brugada ECG pattern resolved upon correction of the ischemia, indicating ischemia as the inducing circumstance. No arrhythmic events have been detected acutely or during the follow‐up. Reported time to resolution ranged from 2 minutes to 5 hours. Provocative challenges using sodium channel blocking agents were performed in 7/17 cases (41%), and all failed to induce a Brugada ECG pattern (BrP Class A). The remaining 10/17 cases (59%) did not undergo provocative testing due to various clinical reasons. Conclusions Myocardial ischemia is a commonly reported etiology of BrP. Importantly, this study found no association between BrP induced by myocardial ischemia and sudden cardiac death or malignant ventricular arrhythmias.

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“…Thus, differentiating these two clinical entities is essential as implantable cardioverter‐defibrillator is not warranted in BrP. The diagnostic criteria 4 suggestive of BrP are shown in Table 1. The clinical implications of BrP remain unknown, although a recent study demonstrated an increased risk of malignant arrhythmias with BrP 5 .…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, BrP treatment includes the management of the underlying condition. Extracellular hyperkalemia, by decreasing the resting membrane potential and inactivation of the sodium channels, can reproduce BrP in susceptible individuals 4 . Unlike congenital BrS, the ion channel dysfunction in hyperkalemia‐induced BrP is transient, a finding which is not reproducible with sodium channel blocking agents.…”

Section: Discussionmentioning

confidence: 99%

“…Abnormal repolarization as a result of ionic imbalance in the epicardium [reduced inward positively charged ionic currents (Na + and Ca 2+ ) and exaggerated outward currents (K + )] more pronounced in the right ventricular outflow tract (RVOT) generates a transmural voltage gradient thus manifesting as the characteristic Brugada ECG patterns 3 . Although mutations in genes encoding various ion channels have been identified, most commonly implicated were the loss‐of‐function mutations in SCN5A (mutation identified in only 20%‐30% of BrS probands) 4 …”

Section: Discussionmentioning

confidence: 99%

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Hyperkalemia induced Brugada phenocopy

Manne

Garg

2021

Journal of Arrhythmia

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Relation of the Brugada Phenocopy to Hyperkalemia (From the International Registry on Brugada Phenocopy)

Cited by 3 publications

References 0 publications

2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias

2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias

Link between Brugada phenocopy and myocardial ischemia: Results from the International Registry on Brugada Phenocopy

Hyperkalemia induced Brugada phenocopy

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