New electrocardiographic criteria for discriminating between Brugada types 2 and 3 patterns and incomplete right bundle branch block.

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State: Public
Version: author
Serval ID
serval:BIB_4A316CFDC50E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
New electrocardiographic criteria for discriminating between Brugada types 2 and 3 patterns and incomplete right bundle branch block.
Journal
Journal of the American College of Cardiology
Author(s)
Chevallier S., Forclaz A., Tenkorang J., Ahmad Y., Faouzi M., Graf D., Schlaepfer J., Pruvot E.
ISSN
1558-3597 (Electronic)
ISSN-L
0735-1097
Publication state
Published
Issued date
2011
Peer-reviewed
Oui
Volume
58
Number
22
Pages
2290-2298
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
OBJECTIVES: The aim of this study was to evaluate new electrocardiographic (ECG) criteria for discriminating between incomplete right bundle branch block (RBBB) and the Brugada types 2 and 3 ECG patterns.
BACKGROUND: Brugada syndrome can manifest as either type 2 or type 3 pattern. The latter should be distinguished from incomplete RBBB, present in 3% of the population.
METHODS: Thirty-eight patients with either type 2 or type 3 Brugada pattern that were referred for an antiarrhythmic drug challenge (AAD) were included. Before AAD, 2 angles were measured from ECG leads V(1) and/or V(2) showing incomplete RBBB: 1) α, the angle between a vertical line and the downslope of the r'-wave, and 2) β, the angle between the upslope of the S-wave and the downslope of the r'-wave. Baseline angle values, alone or combined with QRS duration, were compared between patients with negative and positive results on AAD. Receiver-operating characteristic curves were constructed to identify optimal discriminative cutoff values.
RESULTS: The mean β angle was significantly smaller in the 14 patients with negative results on AAD compared to the 24 patients with positive results on AAD (36 ± 20° vs. 62 ± 20°, p < 0.01). Its optimal cutoff value was 58°, which yielded a positive predictive value of 73% and a negative predictive value of 87% for conversion to type 1 pattern on AAD; α was slightly less sensitive and specific compared with β. When the angles were combined with QRS duration, it tended to improve discrimination.
CONCLUSIONS: In patients with suspected Brugada syndrome, simple ECG criteria can enable discrimination between incomplete RBBB and types 2 and 3 Brugada patterns.
Keywords
Adult, Ajmaline/diagnostic use, Anti-Arrhythmia Agents/diagnostic use, Brugada Syndrome/classification, Brugada Syndrome/diagnosis, Bundle-Branch Block/diagnosis, Electrocardiography/methods, Female, Humans, Male, Predictive Value of Tests, Prospective Studies, ROC Curve, Reproducibility of Results
Pubmed
Web of science
Open Access
Yes
Create date
27/12/2011 18:15
Last modification date
20/08/2019 14:57
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