Atrial Electrophysiological Abnormality in Patients With Brugada Syndrome Assessed by P-Wave Signal-Averaged ECG and Programmed Atrial Stimulation

Background There is evidence that some patients with Brugada syndrome (BS) exhibit atrial tachyarrhythmias including paroxysmal atrial fibrillation. We investigated whether BS associated not only with vulnerability to ventricular fibrillation, but also with vulnerability to atrial fibrillation. Methods and Results In 15 patients with BS and Brugada-type electrocardiogram (ECG) (14 men, 1 woman; age 52.8±12.9 years) and 15 age-matched control patients (12 men, 3 women; age 50.9±18.9 years), the P-wave signal-averaged ECG was recorded, and the filtered P-wave duration was derived from the vector magnitude obtained by X, Y, Z leads. In 11 of the 15 patients with BS and Brugada-type ECG, invasive electrophysiologic testing was conducted. Filtered P-wave duration was significantly increased in patients with BS and Brugada-type ECG in comparison with control subjects (143.2±12.9 vs 129.6±10.1 ms, p