Progressive increase in activation delay during premature stimulation is related to ventricular fibrillation in Brugada syndrome
Introduction The local conduction delay has been deemed to play an important role in the perpetuation of ventricular fibrillation (VF) in Brugada syndrome (BrS). We evaluated the relationship between the activation delay during programmed stimulation and cardiac events in BrS patients. Methods This...
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| Veröffentlicht in: | Journal of cardiovascular electrophysiology 2021-07, Vol.32 (7), p.1939-1946 |
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| container_issue | 7 |
| container_start_page | 1939 |
| container_title | Journal of cardiovascular electrophysiology |
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| creator | Hasegawa, Yuki Izumi, Daisuke Ikami, Yasuhiro Otsuki, Sou Yagihara, Nobue Iijima, Kenichi Chinushi, Masaomi Minamino, Tohru |
| description | Introduction
The local conduction delay has been deemed to play an important role in the perpetuation of ventricular fibrillation (VF) in Brugada syndrome (BrS). We evaluated the relationship between the activation delay during programmed stimulation and cardiac events in BrS patients.
Methods
This study included 47 consecutive BrS patients who underwent an electrophysiological study and received implantable cardiac defibrillator therapy. We divided the patients into two groups based on whether they had developed VF (11 patients) or not (36 patients) during the follow‐up period of 89 ± 53 months. The activation delay was assessed using the interval between the stimulus and the QRS onset during programmed stimulation. The mean increase in delay (MID) was used to characterize the conduction curves.
Results
The MID at the right ventricular outflow tract (RVOT) was significantly greater in patients with VF (4.5 ± 1.2 ms) than in those without VF (2.2 ± 0.9 ms) (p |
| doi_str_mv | 10.1111/jce.15065 |
| format | Article |
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The local conduction delay has been deemed to play an important role in the perpetuation of ventricular fibrillation (VF) in Brugada syndrome (BrS). We evaluated the relationship between the activation delay during programmed stimulation and cardiac events in BrS patients.
Methods
This study included 47 consecutive BrS patients who underwent an electrophysiological study and received implantable cardiac defibrillator therapy. We divided the patients into two groups based on whether they had developed VF (11 patients) or not (36 patients) during the follow‐up period of 89 ± 53 months. The activation delay was assessed using the interval between the stimulus and the QRS onset during programmed stimulation. The mean increase in delay (MID) was used to characterize the conduction curves.
Results
The MID at the right ventricular outflow tract (RVOT) was significantly greater in patients with VF (4.5 ± 1.2 ms) than in those without VF (2.2 ± 0.9 ms) (p < .001). A receiver operating characteristics curve analysis indicated that the optimal cut‐off point for discriminating VF occurrence was 3.3 with 88.9% sensitivity and 91.3% specificity. Furthermore, patients with an MID at the RVOT ≥ 3.3 ms showed significantly higher rates of VF recurrence than those with an MID at the RVOT < 3.3 ms (p < .001). The clinical characteristics, including the signal‐averaged electrocardiogram measurement and VF inducibility were similar between the two groups.
Conclusion
A prolonged MID at the RVOT was associated with VF and maybe an additional electrophysiological risk factor for VF in BrS patients.</description><identifier>ISSN: 1045-3873</identifier><identifier>EISSN: 1540-8167</identifier><identifier>DOI: 10.1111/jce.15065</identifier><identifier>PMID: 33928698</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>activation delay ; Brugada syndrome ; Cardiac arrhythmia ; Conduction ; Defibrillators ; EKG ; electrophysiologic study ; Electrophysiological recording ; Fibrillation ; Heart ; premature stimulation ; Risk factors ; Ventricle ; ventricular fibrillation</subject><ispartof>Journal of cardiovascular electrophysiology, 2021-07, Vol.32 (7), p.1939-1946</ispartof><rights>2021 Wiley Periodicals LLC</rights><rights>2021 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3795-49dd531112b5e3f1751efcea200cf53817d604a52fafa21c8a97efb97b74144e3</cites><orcidid>0000-0003-4908-5220 ; 0000-0002-6366-4221 ; 0000-0003-1554-1056</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjce.15065$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjce.15065$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33928698$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hasegawa, Yuki</creatorcontrib><creatorcontrib>Izumi, Daisuke</creatorcontrib><creatorcontrib>Ikami, Yasuhiro</creatorcontrib><creatorcontrib>Otsuki, Sou</creatorcontrib><creatorcontrib>Yagihara, Nobue</creatorcontrib><creatorcontrib>Iijima, Kenichi</creatorcontrib><creatorcontrib>Chinushi, Masaomi</creatorcontrib><creatorcontrib>Minamino, Tohru</creatorcontrib><title>Progressive increase in activation delay during premature stimulation is related to ventricular fibrillation in Brugada syndrome</title><title>Journal of cardiovascular electrophysiology</title><addtitle>J Cardiovasc Electrophysiol</addtitle><description>Introduction
The local conduction delay has been deemed to play an important role in the perpetuation of ventricular fibrillation (VF) in Brugada syndrome (BrS). We evaluated the relationship between the activation delay during programmed stimulation and cardiac events in BrS patients.
Methods
This study included 47 consecutive BrS patients who underwent an electrophysiological study and received implantable cardiac defibrillator therapy. We divided the patients into two groups based on whether they had developed VF (11 patients) or not (36 patients) during the follow‐up period of 89 ± 53 months. The activation delay was assessed using the interval between the stimulus and the QRS onset during programmed stimulation. The mean increase in delay (MID) was used to characterize the conduction curves.
Results
The MID at the right ventricular outflow tract (RVOT) was significantly greater in patients with VF (4.5 ± 1.2 ms) than in those without VF (2.2 ± 0.9 ms) (p < .001). A receiver operating characteristics curve analysis indicated that the optimal cut‐off point for discriminating VF occurrence was 3.3 with 88.9% sensitivity and 91.3% specificity. Furthermore, patients with an MID at the RVOT ≥ 3.3 ms showed significantly higher rates of VF recurrence than those with an MID at the RVOT < 3.3 ms (p < .001). The clinical characteristics, including the signal‐averaged electrocardiogram measurement and VF inducibility were similar between the two groups.
Conclusion
A prolonged MID at the RVOT was associated with VF and maybe an additional electrophysiological risk factor for VF in BrS patients.</description><subject>activation delay</subject><subject>Brugada syndrome</subject><subject>Cardiac arrhythmia</subject><subject>Conduction</subject><subject>Defibrillators</subject><subject>EKG</subject><subject>electrophysiologic study</subject><subject>Electrophysiological recording</subject><subject>Fibrillation</subject><subject>Heart</subject><subject>premature stimulation</subject><subject>Risk factors</subject><subject>Ventricle</subject><subject>ventricular fibrillation</subject><issn>1045-3873</issn><issn>1540-8167</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp10U1L7DAUBuAginrVhX9AAm68i2rSNE271MGPK4IudF3S5GTI0I_xpB2Z3f3pRuu4EMwmgTy8nOQl5Jizcx7XxcLAOZcsl1tkn8uMJQXP1XY8s0wmolBij_wJYcEYFzmTu2RPiDIt8rLYJ_-fsJ8jhOBXQH1nEHT4OFBtBr_Sg-87aqHRa2pH9N2cLhFaPYwINAy-HZuJ-EAxqgEsHXq6gm5Ab-IlUudr9M2GdfQKx7m2moZ1Z7Fv4ZDsON0EOPraD8jLzfXz7C55eLz9N7t8SIxQpUyy0lop4mPTWoJwXEkOzoBOGTNOioIrm7NMy9Rpp1NuCl0qcHWpapXxLANxQM6m3CX2ryOEoWp9MBAn66AfQ5XKlBXx33ga6ekPuuhH7OJ0UWWqVErKMqq_kzLYh4DgqiX6VuO64qz6qKWKtVSftUR78pU41i3Yb7npIYKLCbz5Bta_J1X3s-sp8h1sWpkU</recordid><startdate>202107</startdate><enddate>202107</enddate><creator>Hasegawa, Yuki</creator><creator>Izumi, Daisuke</creator><creator>Ikami, Yasuhiro</creator><creator>Otsuki, Sou</creator><creator>Yagihara, Nobue</creator><creator>Iijima, Kenichi</creator><creator>Chinushi, Masaomi</creator><creator>Minamino, Tohru</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4908-5220</orcidid><orcidid>https://orcid.org/0000-0002-6366-4221</orcidid><orcidid>https://orcid.org/0000-0003-1554-1056</orcidid></search><sort><creationdate>202107</creationdate><title>Progressive increase in activation delay during premature stimulation is related to ventricular fibrillation in Brugada syndrome</title><author>Hasegawa, Yuki ; Izumi, Daisuke ; Ikami, Yasuhiro ; Otsuki, Sou ; Yagihara, Nobue ; Iijima, Kenichi ; Chinushi, Masaomi ; Minamino, Tohru</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3795-49dd531112b5e3f1751efcea200cf53817d604a52fafa21c8a97efb97b74144e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>activation delay</topic><topic>Brugada syndrome</topic><topic>Cardiac arrhythmia</topic><topic>Conduction</topic><topic>Defibrillators</topic><topic>EKG</topic><topic>electrophysiologic study</topic><topic>Electrophysiological recording</topic><topic>Fibrillation</topic><topic>Heart</topic><topic>premature stimulation</topic><topic>Risk factors</topic><topic>Ventricle</topic><topic>ventricular fibrillation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hasegawa, Yuki</creatorcontrib><creatorcontrib>Izumi, Daisuke</creatorcontrib><creatorcontrib>Ikami, Yasuhiro</creatorcontrib><creatorcontrib>Otsuki, Sou</creatorcontrib><creatorcontrib>Yagihara, Nobue</creatorcontrib><creatorcontrib>Iijima, Kenichi</creatorcontrib><creatorcontrib>Chinushi, Masaomi</creatorcontrib><creatorcontrib>Minamino, Tohru</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiovascular electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hasegawa, Yuki</au><au>Izumi, Daisuke</au><au>Ikami, Yasuhiro</au><au>Otsuki, Sou</au><au>Yagihara, Nobue</au><au>Iijima, Kenichi</au><au>Chinushi, Masaomi</au><au>Minamino, Tohru</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Progressive increase in activation delay during premature stimulation is related to ventricular fibrillation in Brugada syndrome</atitle><jtitle>Journal of cardiovascular electrophysiology</jtitle><addtitle>J Cardiovasc Electrophysiol</addtitle><date>2021-07</date><risdate>2021</risdate><volume>32</volume><issue>7</issue><spage>1939</spage><epage>1946</epage><pages>1939-1946</pages><issn>1045-3873</issn><eissn>1540-8167</eissn><abstract>Introduction
The local conduction delay has been deemed to play an important role in the perpetuation of ventricular fibrillation (VF) in Brugada syndrome (BrS). We evaluated the relationship between the activation delay during programmed stimulation and cardiac events in BrS patients.
Methods
This study included 47 consecutive BrS patients who underwent an electrophysiological study and received implantable cardiac defibrillator therapy. We divided the patients into two groups based on whether they had developed VF (11 patients) or not (36 patients) during the follow‐up period of 89 ± 53 months. The activation delay was assessed using the interval between the stimulus and the QRS onset during programmed stimulation. The mean increase in delay (MID) was used to characterize the conduction curves.
Results
The MID at the right ventricular outflow tract (RVOT) was significantly greater in patients with VF (4.5 ± 1.2 ms) than in those without VF (2.2 ± 0.9 ms) (p < .001). A receiver operating characteristics curve analysis indicated that the optimal cut‐off point for discriminating VF occurrence was 3.3 with 88.9% sensitivity and 91.3% specificity. Furthermore, patients with an MID at the RVOT ≥ 3.3 ms showed significantly higher rates of VF recurrence than those with an MID at the RVOT < 3.3 ms (p < .001). The clinical characteristics, including the signal‐averaged electrocardiogram measurement and VF inducibility were similar between the two groups.
Conclusion
A prolonged MID at the RVOT was associated with VF and maybe an additional electrophysiological risk factor for VF in BrS patients.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33928698</pmid><doi>10.1111/jce.15065</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-4908-5220</orcidid><orcidid>https://orcid.org/0000-0002-6366-4221</orcidid><orcidid>https://orcid.org/0000-0003-1554-1056</orcidid></addata></record> |
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| subjects | activation delay Brugada syndrome Cardiac arrhythmia Conduction Defibrillators EKG electrophysiologic study Electrophysiological recording Fibrillation Heart premature stimulation Risk factors Ventricle ventricular fibrillation |
| title | Progressive increase in activation delay during premature stimulation is related to ventricular fibrillation in Brugada syndrome |
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