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...

Descripción completa

Detalles Bibliográficos
Autores principales: Martini, Nicolò, Testolina, Martina, Toffanin, Gian Luca, Arancio, Rocco, De Mattia, Luca, Cannas, Sergio, Morani, Giovanni, Martini, Bortolo
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