Insights into the location of type I ECG in patients with Brugada syndrome

• Verfasst von: Veltmann, Christian [VerfasserIn]
• Verfasst von: Papavassiliu, Theano [VerfasserIn]
• Verfasst von: Konrad, Torsten [VerfasserIn]
• Verfasst von: Dösch, Christina [VerfasserIn]
• Verfasst von: Kuschyk, Jürgen [VerfasserIn]
• Verfasst von: Streitner, Florian [VerfasserIn]
• Verfasst von: Haghi, Dariusch [VerfasserIn]
• Verfasst von: Michaely, Henrik J. M. [VerfasserIn]
• Verfasst von: Schönberg, Stefan [VerfasserIn]
• Verfasst von: Borggrefe, Martin [VerfasserIn]
• Verfasst von: Wolpert, Christian [VerfasserIn]
• Verfasst von: Schimpf, Rainer [VerfasserIn]
• Titel: Insights into the location of type I ECG in patients with Brugada syndrome
• Titelzusatz: Correlation of ECG and cardiovascular magnetic resonance imaging
• Verf.angabe: C. Veltmann, T. Papavassiliu, T. Konrad, C. Doesch, J. Kuschyk, F. Streitner, D. Haghi, H.J. Michaely, S.O. Schoenberg, M. Borggrefe, C. Wolpert, R. Schimpf
• Jahr: 2012
• Umfang: 8 S.
• Fussnoten: Available online 23 November 2011 ; Gesehen am 18.02.2019
• Titel Quelle: Enthalten in: Heart rhythm
• Ort Quelle: New York, NY [u.a.] : Elsevier, 2004
• Jahr Quelle: 2012
• Band/Heft Quelle: 9(2012), 3, Seite 414-421
• ISSN Quelle: 1556-3871
• DOI: doi:10.1016/j.hrthm.2011.10.032
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Brugada syndrome
• Sach-SW: Cardiovascular magnetic resonance imaging
• Sach-SW: Diagnosis
• Sach-SW: ECG
• Sach-SW: Right ventricular outflow tract
• K10plus-PPN: 1587740257

Abstract

Background - Brugada syndrome is characterized by ST-segment abnormalities in V1-V3. Electrocardiogram (ECG) leads placed in the 3rd and 2nd intercostal spaces (ICSs) increased the sensitivity for the detection of a type I ECG pattern. The anatomic explanation for this finding is pending. - Objective - The purpose of the study was to correlate the location of the Brugada type I ECG with the anatomic location of the right ventricular outflow tract (RVOT). - Methods - Twenty patients with positive ajmaline challenge and 10 patients with spontaneous Brugada type I ECG performed by using 12 right precordial leads underwent cardiovascular magnetic resonance imaging (CMRI). The craniocaudal and lateral extent of the RVOT and maximal RVOT area were determined. Type I ECG pattern and maximal ST-segment elevation were correlated to extent and maximal RVOT area, respectively. - Results - In all patients, Brugada type I pattern was found in the 3rd ICS in sternal and left-parasternal positions. RVOT extent determined by using CMRI included the 3rd ICS in all patients. Maximal RVOT area was found in 3 patients in the 2nd ICS, in 5 patients in the 4th ICS, and in 22 patients in the 3rd ICS. CMRI predicted type I pattern with a sensitivity of 97.2%, specificity of 91.7%, positive predictive value of 88.6%, and negative predictive value of 98.0%. Maximal RVOT area coincided with maximal ST-segment elevation in 29 of 30 patients. - Conclusion - RVOT localization determined by using CMRI correlates highly with the type I Brugada pattern. Lead positioning according to RVOT location improves the diagnosis of Brugada syndrome.