Clarifying the arrhythmogenic substrate for Brugada syndrome

Int Heart J. 2011;52(5):290-4. doi: 10.1536/ihj.52.290.

Abstract

The right ventricular outflow tract (RVOT) is considered the arrhythmogenic region that gives rise to Brugada syndrome. To obtain a better understanding of this substrate, we performed electroanatomic mapping of the right ventricle (RV) in patients with Brugada syndrome. The RV was mapped electroanatomically with the CARTO system in 11 patients with asymptomatic Brugada syndrome but in whom ventricular fibrillation was induced by programmed ventricular stimulation, and in 5 control patients. The low voltage zone area (< 1.5 mV) was larger (16.1% versus 7.8%, P < 0.01) and the bipolar electrogram duration was greater (81.6 ± 7.8 ms versus 53.4 ± 5.6 ms, P < 0.01) in the patients with Brugada syndrome versus the control patients; the bipolar electrogram duration was greater in the septal portion and free wall of the RVOT. Our data suggest that regional endocardial conduction slowing based on structural abnormalities exists at the RVOT in Brugada syndrome.

MeSH terms

  • Adult
  • Aged
  • Arrhythmogenic Right Ventricular Dysplasia / diagnosis
  • Arrhythmogenic Right Ventricular Dysplasia / physiopathology
  • Brugada Syndrome / diagnosis*
  • Brugada Syndrome / physiopathology*
  • Cardiac Pacing, Artificial
  • Diagnosis, Differential
  • Electrocardiography / instrumentation*
  • Electrophysiologic Techniques, Cardiac / instrumentation*
  • Endocardium / physiopathology*
  • Female
  • Heart Ventricles / physiopathology*
  • Humans
  • Image Processing, Computer-Assisted / instrumentation*
  • Imaging, Three-Dimensional / instrumentation*
  • Male
  • Middle Aged
  • Reference Values
  • Signal Processing, Computer-Assisted / instrumentation*
  • Tachycardia, Ventricular / diagnosis
  • Tachycardia, Ventricular / physiopathology
  • Ventricular Fibrillation / diagnosis
  • Ventricular Fibrillation / physiopathology