High-density epicardial mapping in Brugada syndrome: Depolarization and repolarization abnormalities

被引：29

作者：

Pannone, Luigi ^{[1
]}

Monaco, Cinzia ^{[1
]}

Sorgente, Antonio ^{[1
]}

Vergara, Pasquale ^{[1
]}

Calburean, Paul-Adrian ^{[1
]}

Gauthey, Anais ^{[1
]}

Bisignani, Antonio ^{[1
]}

Kazawa, Shuichiro ^{[1
]}

Strazdas, Antanas ^{[1
]}

Mojica, Joerelle ^{[1
]}

Lipartiti, Felicia ^{[1
]}

Al Housari, Maysam ^{[1
]}

Miraglia, Vincenzo ^{[1
]}

Rizzi, Sergio ^{[1
]}

Sofianos, Dimitrios ^{[1
]}

Cecchini, Federico ^{[1
]}

Osorio, Thiago Guimaraes ^{[1
]}

Paparella, Gaetano ^{[1
]}

Ramak, Robbert ^{[1
]}

Overeinder, Ingrid ^{[1
]}

Bala, Gezim ^{[1
]}

Almorad, Alexandre ^{[1
]}

Stroker, Erwin ^{[1
]}

Pappaert, Gudrun ^{[1
]}

Sieira, Juan ^{[1
]}

Brugada, Pedro ^{[1
]}

La Meir, Mark ^{[2
]}

Chierchia, Gian Battista ^{[1
]}

de Asmundis, Carlo ^{[1
]}

机构：

[1] Vrije Univ Brussel, Univ Ziekenhuis Brussel, European Reference Networks Guard Heart,Heart Rhy, Postgrad Program Cardiac Electrophysiol & Pacing, Brussels, Belgium

[2] Vrije Univ Brussel, Univ Ziekenhuis Brussel, Cardiac Surg Dept, Brussels, Belgium

来源：

HEART RHYTHM | 2022年 / 19卷 / 03期

关键词：

Brugada syndrome; Electrocardiographic imaging; High-density mapping; Sudden cardiac death; Ventricular tachy-cardia ablation; VENTRICULAR OUTFLOW TRACT; SUDDEN CARDIAC DEATH; ST-SEGMENT ELEVATION; SUBSTRATE; FIBRILLATION; ELECTROGRAM; PREVENTION; PHENOTYPE; MODEL;

D O I：

10.1016/j.hrthm.2021.09.032

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND The pathogenesis of Brugada syndrome (BrS) and consequently of abnormal electrograms (aEGMs) found in the epicardium of the right ventricular outflow tract (RVOT-EPI) is controversial.& nbsp;OBJECTIVE The purpose of this study was to analyze aEGM from high-density RVOT-EPI electroanatomic mapping (EAM).& nbsp;METHODS All patients undergoing RVOT-EPI EAM with the HD-Grid catheter for BrS were retrospectively included. Maps were acquired before and after ajmaline, and all patients had concomitant noninvasive electrocardiographic imaging with annotation of RVOT-EPI latest activation time (RVOTat). High-frequency potentials (HFPs) were defined as ventricular potentials occurring during or after the far -field ventricular EGM showing a local activation time (HFPat). Low-frequency potentials (LFPs) were defined as aEGMs occurring after near -field ventricular activation showing fractionation or delayed components. Their activation time from surface ECG was defined as LFPat.& nbsp;RESULTS Fifteen consecutive patients were included in the study. At EAM before ajmaline, 7 patients (46.7%) showed LFPs. All patients showed HFPs before and after ajmaline and LFPs after ajmaline. Mean HFPat (134.4 vs 65.3 ms, P <.001), mean LFPat (224.6 vs 113.6 ms, P <.001), and mean RVOTat (124.8 vs 55.9 ms, P <.001) increased after ajmaline. RVOTat correlated with HFPat before (r = 0.76) and after ajmaline (r = 0.82), while RVOTat was shorter than LFPat before (P <.001) and after ajmaline (P <.001). BrS patients with history of aborted sudden cardiac death had longer aEGMs after ajmaline.& nbsp;CONCLUSION Two different types of aEGMs are described from BrS high-density epicardial mapping. This might correlate with depolarization and repolarization abnormalities. (C)& nbsp;2021 Heart Rhythm Society.All rights reserved.& nbsp;

引用

页码：397 / 404

页数：8