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Simultaneous Non‐Invasive Epicardial and Endocardial Mapping in Patients With Brugada Syndrome: New Insights Into Arrhythmia Mechanisms
| Content Provider | Semantic Scholar |
|---|---|
| Author | Rudic, Boris Chaykovskaya, Maria Tsyganov, A. Kalinin, Vitaly V. Tueluemen, Erol Papavassiliu, Theano Doesch, Christina Liebe, Volker Kuschyk, Juergen Röger, Susanne Battrawy, Ibrahim El‐ Akin, Ibrahim Yakovleva, Marina P. Zaklyazminskaya, Elena V. Shestak, A. A. Kim, Stanislav Y. Chmelevsky, Mikhail Borggrefe, Martin |
| Copyright Year | 2016 |
| Abstract | BACKGROUND The underlying mechanisms of Brugada syndrome (BrS) are not completely understood. Recent studies provided evidence that the electrophysiological substrate, leading to electrocardiogram abnormalities and/or ventricular arrhythmias, is located in the right ventricular outflow tract (RVOT). The purpose of this study was to examine abnormalities of epicardial and endocardial local unipolar electrograms by simultaneous noninvasive mapping in patients with BrS. METHODS AND RESULTS Local epicardial and endocardial unipolar electrograms were analyzed using a novel noninvasive epi- and endocardial electrophysiology system (NEEES) in 12 patients with BrS and 6 with right bundle branch block for comparison. Fifteen normal subjects composed the control group. Observed depolarization abnormalities included fragmented electrograms in the anatomical area of RVOT endocardially and epicardially, significantly prolonged activation time in the RVOT endocardium (65±20 vs 38±13 ms in controls; P=0.008), prolongation of the activation-recovery interval in the RVOT epicardium (281±34 vs 247±26 ms in controls; P=0.002). Repolarization abnormalities included a larger area of ST-segment elevation >2 mV and T-wave inversions. Negative voltage gradient (-2.5 to -6.0 mV) between epicardium and endocardium of the RVOT was observed in 8 of 12 BrS patients, not present in patients with right bundle branch block or in controls. CONCLUSIONS Abnormalities of epicardial and endocardial electrograms associated with depolarization and repolarization properties were found using NEEES exclusively in the RVOT of BrS patients. These findings support both, depolarization and repolarization abnormalities, being operative at the same time in patients with BrS. |
| Starting Page | 429 |
| Ending Page | 440 |
| Page Count | 12 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://jaha.ahajournals.org/content/ahaoa/5/11/e004095.full.pdf?download=true |
| Alternate Webpage(s) | https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/56/7d/JAH3-5-e004095.PMC5210320.pdf |
| PubMed reference number | 27930354 |
| Volume Number | 5 |
| Journal | Journal of the American Heart Association |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Brugada Syndrome (disorder) Bundle-Branch Block Chromosome inversion Congenital Abnormality Congenital Heart Defects Electrocardiography Endocardial Fibroelastosis Endocardium Epicardium Large Patients Right bundle branch block Structure of outflow tract of right ventricle Structure of right branch of atrioventricular bundle Tooth Abnormalities Ventricular arrhythmia |
| Content Type | Text |
| Resource Type | Article |
