Tpeak-Tend and Tpeak-Tend Dispersion as Risk Factors for Ventricular Tachycardia/Ventricular Fibrillation in Patients With the Brugada Syndrome

Tpeak-Tend and Tpeak-Tend Dispersion as Risk Factors for Ventricular Tachycardia/Fibrillation in Patients With the Brugada Syndrome Jesus Castro Hevia, Charles Antzelevitch, Francisco Tornés Bárzaga, Margarita Dorantes Sánchez, Francisco Dorticós Balea, Roberto Zayas Molina, Miguel A. Quiñones Pérez, Yanela Fayad Rodríguez The T-peak-Tend interval (Tp-e) in the electrocardiogram (ECG) has been reported to predict life-threatening arrhythmias in the long QT syndrome. Our principal objective was to evaluate this and other electrocardiographic parameters as risk factors for recurrence of life-threatening cardiac events in Brugada syndrome (BS) patients. Twenty-nine patients with the ECG pattern of BS and 29 controls were studied with a follow-up of 42.7 ± 24.4 months. A QTc >460 ms in V2, Tp-e, and Tp-e dispersion, but not QT dispersion, were significantly correlated with the occurrence of life-threatening arrhythmic events in patients with BS, suggesting that these parameters may be useful in risk stratification of patients with BS. Our objective in this study was to evaluate Tpeak-Tend interval (Tp-e) and other electrocardiographic parameters as risk factors for recurrence of life-threatening cardiac events in patients with the Brugada syndrome (BS). The Tp-e interval in the electrocardiogram (ECG) has been reported to predict life-threatening arrhythmias in the long QT syndrome. Twenty-nine patients with the ECG pattern of BS and 29 healthy age- and gender-matched controls were studied. The follow-up period was 42.65 ± 24.42 months (range 11 to 108 months). Upon presentation, five patients had suffered aborted sudden death, five syncope, and two presyncope. Eleven patients with the ECG pattern of BS had a prolonged (>460 ms) QTc in V2but usually not in inferior or left leads. No patient had abnormally prolonged QT dispersion. Programmed electrical stimulation induced ventricular tachycardia/fibrillation in 5 out of 26 patients. Inducibility did not predict recurrence of events. Cardioverter-defibrillators were implanted in 14 patients (all symptomatic and two asymptomatic). During follow-up, nine symptomatic patients experienced recurrences. Previous cardiac events and a QTc >460 ms in V2were significant risk factors (p = 0.00002 and p = 0.03, respectively). Tp-e and Tp-e dispersion were significantly prolonged in patients with recurrences versus patients without events (104.4 and 35.6 ms vs. 87.4 and 23.2 ms; p = 0.006 and p = 0.03, respectively) or contr