Conduction Disturbance and Risk Stratification of Patients with Brugada-Type Electrocardiogram

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Background: We sometimes encounter patients with Brugada-type electrocardiogram (ECG), but it's difficult to pick up high risk patients. Previous studies have shown that Brugada syndrome patients have variety of conduction disease such as sick sinus syndrome and intra-ventricular conduction disease, but thease conduction disturbances are not included in diagnostic criteria of Brugada syndrome. We investigated whether we can predict high risk patients from 12-lead ECG. Methods: We retrospectively studied 43 consecutive patients (mean age 52.2±15.2 years old, 40 males) who had Brugada-type ECG between August 2000 and August 2010. We divided them into 2 groups, patients with cardiac events (high risk group) and those without cardiac events (low risk group). Cardiac events were defined as sustained ventricular tachycardia, ventricular fibrillation or sudden cardiac death. The 12-lead ECG findings such as P wave, PR, QRS, QTc duration, J wave and T wave amplitude in lead-V1 were compared between the 2 groups. Results: Among 43 patients, 13 patients (30.2%) were in high risk group, and 30 patients (69.7%) were in low risk group. QRS duration (113.0±19.4 ms vs 99.0±13.0 ms; p=0.0407) and QTc duration (425.0±14.5 ms vs 409.0±20.0 ms; p=0.0095) were significantly longer in high risk group. There wasn't significant difference in 2 groups in P wave, PR duration, J wave and T wave amplitude. Conclusion: QRS duration and QTc duration in 12-lead ECG can be the predictors of cardiac events in patients with Brugada type ECG.
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Conduction Disturbance and Risk Stratification of Patients with Brugada-Type Electrocardiogram

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