Cargando…
Role of Provocable Brugada ECG Pattern in The Correct Risk Stratification for Major Arrhythmic Events
The so-called Brugada syndrome (BS), first called precordial early repolarization syndrome (PERS), is characterized by the association of a fascinating electrocardiographic pattern, namely an aspect resembling right bundle branch block with a coved and sometime upsloping ST segment elevation in the...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7958847/ https://www.ncbi.nlm.nih.gov/pubmed/33801474 http://dx.doi.org/10.3390/jcm10051025 |
_version_ | 1783664872401141760 |
---|---|
author | Martini, Nicolò Testolina, Martina Toffanin, Gian Luca Arancio, Rocco De Mattia, Luca Cannas, Sergio Morani, Giovanni Martini, Bortolo |
author_facet | Martini, Nicolò Testolina, Martina Toffanin, Gian Luca Arancio, Rocco De Mattia, Luca Cannas, Sergio Morani, Giovanni Martini, Bortolo |
author_sort | Martini, Nicolò |
collection | PubMed |
description | The so-called Brugada syndrome (BS), first called precordial early repolarization syndrome (PERS), is characterized by the association of a fascinating electrocardiographic pattern, namely an aspect resembling right bundle branch block with a coved and sometime upsloping ST segment elevation in the precordial leads, and major ventricular arrhythmic events that could rarely lead to sudden death. Its electrogenesis has been related to a conduction delay mostly, but not only, located on the right ventricular outflow tract (RVOT), probably due to a progressive fibrosis of the conduction system. Many tests have been proposed to identify people at risk of sudden death and, among all, ajmaline challenge, thanks to its ability to enhance latent conduction defects, became so popular, even if its role is still controversial as it is neither specific nor sensitive enough to guide further invasive investigations and managements. Interestingly, a type 1 pattern has also been induced in many other cardiac diseases or systemic diseases with a cardiac involvement, such as long QT syndrome (LQTS), arrhythmogenic right ventricular cardiomyopathy (ARVC), hypertrophic cardiomyopathy (HCM) and myotonic dystrophy, without any clear arrhythmic risk profile. Evidence-based studies clearly showed that a positive ajmaline test does not provide any additional information on the risk stratification for major ventricular arrhythmic events on asymptomatic individuals with a non-diagnostic Brugada ECG pattern. |
format | Online Article Text |
id | pubmed-7958847 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-79588472021-03-16 Role of Provocable Brugada ECG Pattern in The Correct Risk Stratification for Major Arrhythmic Events Martini, Nicolò Testolina, Martina Toffanin, Gian Luca Arancio, Rocco De Mattia, Luca Cannas, Sergio Morani, Giovanni Martini, Bortolo J Clin Med Review The so-called Brugada syndrome (BS), first called precordial early repolarization syndrome (PERS), is characterized by the association of a fascinating electrocardiographic pattern, namely an aspect resembling right bundle branch block with a coved and sometime upsloping ST segment elevation in the precordial leads, and major ventricular arrhythmic events that could rarely lead to sudden death. Its electrogenesis has been related to a conduction delay mostly, but not only, located on the right ventricular outflow tract (RVOT), probably due to a progressive fibrosis of the conduction system. Many tests have been proposed to identify people at risk of sudden death and, among all, ajmaline challenge, thanks to its ability to enhance latent conduction defects, became so popular, even if its role is still controversial as it is neither specific nor sensitive enough to guide further invasive investigations and managements. Interestingly, a type 1 pattern has also been induced in many other cardiac diseases or systemic diseases with a cardiac involvement, such as long QT syndrome (LQTS), arrhythmogenic right ventricular cardiomyopathy (ARVC), hypertrophic cardiomyopathy (HCM) and myotonic dystrophy, without any clear arrhythmic risk profile. Evidence-based studies clearly showed that a positive ajmaline test does not provide any additional information on the risk stratification for major ventricular arrhythmic events on asymptomatic individuals with a non-diagnostic Brugada ECG pattern. MDPI 2021-03-02 /pmc/articles/PMC7958847/ /pubmed/33801474 http://dx.doi.org/10.3390/jcm10051025 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Martini, Nicolò Testolina, Martina Toffanin, Gian Luca Arancio, Rocco De Mattia, Luca Cannas, Sergio Morani, Giovanni Martini, Bortolo Role of Provocable Brugada ECG Pattern in The Correct Risk Stratification for Major Arrhythmic Events |
title | Role of Provocable Brugada ECG Pattern in The Correct Risk Stratification for Major Arrhythmic Events |
title_full | Role of Provocable Brugada ECG Pattern in The Correct Risk Stratification for Major Arrhythmic Events |
title_fullStr | Role of Provocable Brugada ECG Pattern in The Correct Risk Stratification for Major Arrhythmic Events |
title_full_unstemmed | Role of Provocable Brugada ECG Pattern in The Correct Risk Stratification for Major Arrhythmic Events |
title_short | Role of Provocable Brugada ECG Pattern in The Correct Risk Stratification for Major Arrhythmic Events |
title_sort | role of provocable brugada ecg pattern in the correct risk stratification for major arrhythmic events |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7958847/ https://www.ncbi.nlm.nih.gov/pubmed/33801474 http://dx.doi.org/10.3390/jcm10051025 |
work_keys_str_mv | AT martininicolo roleofprovocablebrugadaecgpatterninthecorrectriskstratificationformajorarrhythmicevents AT testolinamartina roleofprovocablebrugadaecgpatterninthecorrectriskstratificationformajorarrhythmicevents AT toffaningianluca roleofprovocablebrugadaecgpatterninthecorrectriskstratificationformajorarrhythmicevents AT aranciorocco roleofprovocablebrugadaecgpatterninthecorrectriskstratificationformajorarrhythmicevents AT demattialuca roleofprovocablebrugadaecgpatterninthecorrectriskstratificationformajorarrhythmicevents AT cannassergio roleofprovocablebrugadaecgpatterninthecorrectriskstratificationformajorarrhythmicevents AT moranigiovanni roleofprovocablebrugadaecgpatterninthecorrectriskstratificationformajorarrhythmicevents AT martinibortolo roleofprovocablebrugadaecgpatterninthecorrectriskstratificationformajorarrhythmicevents |