Usefulness of Multichannel Holter ECG Recording in the Third Intercostal Space for Detecting Type 1 Brugada ECG: Comparison with Repeated 12‐Lead ECGs

Shimeno, Kenji; Takagi, Masahiko; Maeda, Keiko; Tatsumi, Hiroaki; Doi, and Atsushi; Yoshiyama, Minoru

doi:10.1111/j.1540-8167.2009.01490.x

Cited by 51 publications

(30 citation statements)

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“…Additionally, they reported that the instability and heterogeneity of repolarization within the RVOT epicardium was associated with arrhythmogenesis in Brugada syndrome [23]. Shimeno et al [24] reported that Holter-ECG recording at the third intercostal space was more sensitive for detecting spontaneous type-1 ECG patterns than that at the standard positions. Another group reported that the electrophysiological mechanism in patients with Br-S involved delayed depolarization over the anterior aspect of the RVOT epicardium, and that catheter ablation over the abnormal depolarization was effective for eliminating VF and normalizing the Brugada ECG pattern [25].…”

Section: Discussionmentioning

confidence: 97%

Utility of T-wave alternans during night time as a predictor for ventricular fibrillation in patients with Brugada syndrome

et al. 2015

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The prognostic value of T-wave alternans (TWA) during the night time in patients with Brugada syndrome (Br-S) remains unknown. We assessed TWA for risk stratification using 24-h multichannel Holter electrocardiogram (24-M-ECG) in Br-S. We enrolled 129 patients with Br-S [grouped according to histories of ventricular fibrillation (VF), n = 16; syncope, n = 10; or no symptoms (asymptomatic), n = 103] and 11 controls. Precordial electrodes were attached to the third (3L-V1, 3L-V2) and fourth (4L-V1, 4L-V2 and 4L-V5) intercostal spaces. We measured the values of maximum TWA (max-TWA) during the night time (12 a.m.-6 a.m.) and the day time (12 p.m.-6 p.m.) and calculated parameters of heart rate variability. Compared to the asymptomatic and control groups, the VF and syncope groups showed significantly greater 3L-V2 max-TWA during the night time. The cutoff value for the 3L-V2 max-TWA during the night time was determined as 20 µV (sensitivity 94 % and specificity 48 %; p = 0.01). Multivariate analysis revealed that 3L-V2 max-TWA during the night time ≥20 µV and previous VF episodes were independent predictors of future VF episodes. During a mean follow-up period of 68 ± 37 months, 16 patients experienced VF episodes. The incidence of VF episodes was the highest during the night time (p < 0.001). The 3L-V2 max-TWA during the night time may be a useful predictor for VF episodes in patients with Br-S.

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Section: Discussionmentioning

confidence: 97%

Utility of T-wave alternans during night time as a predictor for ventricular fibrillation in patients with Brugada syndrome

et al. 2015

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“…24 Serial 12-leads ECG Holter recordings (at the fourth, third, and second intercostal space) are, therefore, of paramount importance to detect a spontaneous ECG pattern in asymptomatic subjects. 25 Conflicting evidence exists on the prognostic value of PVS in BS. The second consensus report on BS, published in 2005, considered the PVS as the cornerstone of the therapeutic strategy.…”

Section: Discussionmentioning

confidence: 99%

Meta-Analysis on Risk Stratification of Asymptomatic Individuals With the Brugada Phenotype

Letsas

Liu

Shao

et al. 2015

The American Journal of Cardiology

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“…A higher precordial position might have increased the prevalence of type 1 BrS33; therefore, the prevalence of spontaneous and drug‐induced type 1 BrS may be underestimated.…”

Section: Discussionmentioning

confidence: 99%

Long‐Term Prognosis of Brugada‐Type ECG and ECG With Atypical ST‐Segment Elevation in the Right Precordial Leads Over 20 Years: Results From the Circulatory Risk in Communities Study (CIRCS)

Tsuneoka

Takagi

Murakoshi

et al. 2016

JAHA

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BackgroundBrugada syndrome is recognized as being associated with sudden cardiac death; however, the prevalence of non–type 1 Brugada‐type ECG (BrS) or atypical ST‐segment elevation in the right precordial leads (STERP) and the long‐term prognosis for those patients remain unknown.Methods and ResultsWe analyzed standard 12‐lead ECGs of 7178 apparently healthy participants (age range 40–64 years) who underwent health checkups from 1982 to 1986 in the Circulatory Risk in Communities Study, a prospective, large, community‐based cohort study in Japan. ECGs with J point amplitude ≥0.2 mV in the right precordial leads were divided into 3 groups: (1) type 1 BrS, (2) type 2 or 3 BrS (non‐type 1 BrS), and (3) STERP. The others served as the non–ST‐segment elevation group. We identified 8 participants (0.1%) with type1 BrS, 84 (1.2%) with non–type 1 BrS, and 228 (3.2%) with STERP. During a median follow‐up of 18.7 years (133 987.0 person‐years), sudden cardiac death was observed in no participants (0.0%) with type 1 BrS, in 1 (1.2%) with non–type 1 BrS, in 7 (3.1%) with STERP, and in 50 (0.7%) with non–ST‐segment elevation. Participants with STERP had a markedly elevated risk of sudden cardiac death (multivariable hazard ratio 3.9, 95% CI 1.7–9.0).Conclusions STERP was associated with an elevated risk of sudden cardiac death in a middle‐aged population.

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Usefulness of Multichannel Holter ECG Recording in the Third Intercostal Space for Detecting Type 1 Brugada ECG: Comparison with Repeated 12‐Lead ECGs

Abstract: Multichannel Holter ECG recording in the third intercostal space is more sensitive and useful for the diagnosis of type 1 Brugada ECG than repeated 12-lead ECGs or multichannel Holter ECG in the standard position.

Cited by 51 publications

References 29 publications

Utility of T-wave alternans during night time as a predictor for ventricular fibrillation in patients with Brugada syndrome

Utility of T-wave alternans during night time as a predictor for ventricular fibrillation in patients with Brugada syndrome

Meta-Analysis on Risk Stratification of Asymptomatic Individuals With the Brugada Phenotype

Long‐Term Prognosis of Brugada‐Type ECG and ECG With Atypical ST‐Segment Elevation in the Right Precordial Leads Over 20 Years: Results From the Circulatory Risk in Communities Study (CIRCS)

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