High-density epicardial mapping in Brugada syndrome: Depolarization and repolarization abnormalities

Luigi Pannone, Cinzia Monaco, Antonio Sorgente, Pasquale Vergara, Paul-Adrian Calburean, Anaïs Gauthey, Antonio Bisignani, Shuichiro Kazawa, Antanas Strazdas, Joerelle Mojica, Felicia Lipartiti, Maysam Al Housari, Vincenzo Miraglia, Sergio Rizzi, Dimitrios Sofianos, Federico Cecchini, Thiago Guimarães Osório, Gaetano Paparella, Robbert Ramak, Ingrid OvereinderGezim Bala, Alexandre Almorad, Erwin Ströker, Gudrun Pappaert, Juan Sieira, Pedro Brugada, Mark La Meir, Gian Battista Chierchia, Carlo de Asmundis

Onderzoeksoutput: Articlepeer review

29 Citaten (Scopus)

Samenvatting

BACKGROUND: The pathogenesis of Brugada syndrome (BrS) and consequently of abnormal electrograms (aEGMs) found in the epicardium of the right ventricular outflow tract (RVOT-EPI) is controversial.

OBJECTIVE: The purpose of this study was to analyze aEGM from high-density RVOT-EPI electroanatomic mapping (EAM).

METHODS: All patients undergoing RVOT-EPI EAM with the HD-Grid catheter for BrS were retrospectively included. Maps were acquired before and after ajmaline, and all patients had concomitant noninvasive electrocardiographic imaging with annotation of RVOT-EPI latest activation time (RVOTat). High-frequency potentials (HFPs) were defined as ventricular potentials occurring during or after the far-field ventricular EGM showing a local activation time (HFPat). Low-frequency potentials (LFPs) were defined as aEGMs occurring after near-field ventricular activation showing fractionation or delayed components. Their activation time from surface ECG was defined as LFPat.

RESULTS: Fifteen consecutive patients were included in the study. At EAM before ajmaline, 7 patients (46.7%) showed LFPs. All patients showed HFPs before and after ajmaline and LFPs after ajmaline. Mean HFPat (134.4 vs 65.3 ms, P <.001), mean LFPat (224.6 vs 113.6 ms, P <.001), and mean RVOTat (124.8 vs 55.9 ms, P <.001) increased after ajmaline. RVOTat correlated with HFPat before (ρ = 0.76) and after ajmaline (ρ = 0.82), while RVOTat was shorter than LFPat before (P <.001) and after ajmaline (P <.001). BrS patients with history of aborted sudden cardiac death had longer aEGMs after ajmaline.

CONCLUSION: Two different types of aEGMs are described from BrS high-density epicardial mapping. This might correlate with depolarization and repolarization abnormalities.

Originele taal-2English
Pagina's (van-tot)397-404
Aantal pagina's8
TijdschriftHeart Rhythm
Volume19
Nummer van het tijdschrift3
Vroegere onlinedatum2021
DOI's
StatusPublished - mrt 2022

Bibliografische nota

Copyright © 2021 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

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