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Prediction of Ventricular Arrhythmias in Patients With a Spontaneous Brugada Type 1 Pattern: The Key Is in the Electrocardiogram

Prediction of Ventricular Arrhythmias in Patients With a Spontaneous Brugada Type 1 Pattern: The Key Is in the Electrocardiogram

Antoine Delinière, Adrian Baranchuk, Joris Giai, Francis Bessiere, Delphine Maucort-Boulch, Pascal Defaye, Eloi Marijon, Olivier Le Vavasseur, Dan Dobreanu, Alina Scridon, Antoine Da Costa, Etienne Delacrétaz, etc.

Europace. 2019 Sep 1;21(9):1400-1409.

PMID: 31177270

Abstract:

Aims:
There is currently no reliable tool to quantify the risks of ventricular fibrillation or sudden cardiac arrest (VF/SCA) in patients with spontaneous Brugada type 1 pattern (BrT1). Previous studies showed that electrocardiographic (ECG) markers of depolarization or repolarization disorders might indicate elevated risk. We aimed to design a VF/SCA risk prediction model based on ECG analyses for adult patients with spontaneous BrT1.
Methods and results:
This retrospective multicentre international study analysed ECG data from 115 patients (mean age 45.1 ± 12.8 years, 105 males) with spontaneous BrT1. Of these, 45 patients had experienced VF/SCA and 70 patients did not experience VF/SCA. Among 10 ECG markers, a univariate analysis showed significant associations between VF/SCA and maximum corrected Tpeak-Tend intervals ≥100 ms in precordial leads (LMaxTpec) (P < 0.001), BrT1 in a peripheral lead (pT1) (P = 0.004), early repolarization in inferolateral leads (ER) (P < 0.001), and QRS duration ≥120 ms in lead V2 (P = 0.002). The Cox multivariate analysis revealed four predictors of VF/SCA: the LMaxTpec [hazard ratio (HR) 8.3, 95% confidence interval (CI) 2.4-28.5; P < 0.001], LMaxTpec + ER (HR 14.9, 95% CI 4.2-53.1; P < 0.001), LMaxTpec + pT1 (HR 17.2, 95% CI 4.1-72; P < 0.001), and LMaxTpec + pT1 + ER (HR 23.5, 95% CI 6-93; P < 0.001). Our multidimensional penalized spline model predicted the 1-year risk of VF/SCA, based on age and these markers.
Conclusion:
LMaxTpec and its association with pT1 and/or ER indicated elevated VF/SCA risk in adult patients with spontaneous BrT1. We successfully developed a simple risk prediction model based on age and these ECG markers.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
AP331002701	PT1		331002-70-1	Price

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