Standard ECG in Brugada Syndrome as a Marker of Prognosis: From Risk Stratification to Pathophysiological Insights
Background The 12‐lead ECG plays a key role in the diagnosis of Brugada syndrome (BrS). Since the spontaneous type 1 ECG pattern was first described, several other ECG signs have been linked to arrhythmic risk, but results are conflicting. Methods and Results We performed a systematic review to clar...
| मुख्य लेखकों: | , , , , , , , , , |
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| स्वरूप: | लेख |
| भाषा: | English |
| प्रकाशित: |
Wiley
2021-05-01
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| श्रृंखला: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| विषय: | |
| ऑनलाइन पहुंच: | https://www.ahajournals.org/doi/10.1161/JAHA.121.020767 |
| _version_ | 1827346300481306624 |
|---|---|
| author | Francesco Vitali Alessandro Brieda Cristina Balla Rita Pavasini Elisabetta Tonet Matteo Serenelli Roberto Ferrari Pietro Delise Claudio Rapezzi Matteo Bertini |
| author_facet | Francesco Vitali Alessandro Brieda Cristina Balla Rita Pavasini Elisabetta Tonet Matteo Serenelli Roberto Ferrari Pietro Delise Claudio Rapezzi Matteo Bertini |
| author_sort | Francesco Vitali |
| collection | DOAJ |
| description | Background The 12‐lead ECG plays a key role in the diagnosis of Brugada syndrome (BrS). Since the spontaneous type 1 ECG pattern was first described, several other ECG signs have been linked to arrhythmic risk, but results are conflicting. Methods and Results We performed a systematic review to clarify the associations of these specific ECG signs with the risk of syncope, sudden death, or equivalents in patients with BrS. The literature search identified 29 eligible articles comprising overall 5731 patients. The ECG findings associated with an incremental risk of syncope, sudden death, or equivalents (hazard ratio ranging from 1.1–39) were the following: localization of type 1 Brugada pattern (in V2 and peripheral leads), first‐degree atrioventricular block, atrial fibrillation, fragmented QRS, QRS duration >120 ms, R wave in lead aVR, S wave in L1 (≥40 ms, amplitude ≥0.1 mV, area ≥1 mm2), early repolarization pattern in inferolateral leads, ST‐segment depression, T‐wave alternans, dispersion of repolarization, and Tzou criteria. Conclusions At least 12 features of standard ECG are associated with a higher risk of sudden death in BrS. A multiparametric risk assessment approach based on ECG parameters associated with clinical and genetic findings could help improve current risk stratification scores of patients with BrS and warrants further investigation. Registration URL: https://www.crd.york.ac.uk/prospero/. Unique identifier: CRD42019123794. |
| first_indexed | 2024-03-07T23:26:07Z |
| format | Article |
| id | doaj.art-cedd4d3bd176460f860acdbb1771ce7f |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-03-07T23:26:07Z |
| publishDate | 2021-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-cedd4d3bd176460f860acdbb1771ce7f2024-02-21T04:33:36ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-05-01101010.1161/JAHA.121.020767Standard ECG in Brugada Syndrome as a Marker of Prognosis: From Risk Stratification to Pathophysiological InsightsFrancesco Vitali0Alessandro Brieda1Cristina Balla2Rita Pavasini3Elisabetta Tonet4Matteo Serenelli5Roberto Ferrari6Pietro Delise7Claudio Rapezzi8Matteo Bertini9Cardiological Center University of Ferrara ItalyCardiological Center University of Ferrara ItalyCardiological Center University of Ferrara ItalyCardiological Center University of Ferrara ItalyCardiological Center University of Ferrara ItalyCardiological Center University of Ferrara ItalyCardiological Center University of Ferrara ItalyCardiology Division Ospedale Pederzoli Verona ItalyCardiological Center University of Ferrara ItalyCardiological Center University of Ferrara ItalyBackground The 12‐lead ECG plays a key role in the diagnosis of Brugada syndrome (BrS). Since the spontaneous type 1 ECG pattern was first described, several other ECG signs have been linked to arrhythmic risk, but results are conflicting. Methods and Results We performed a systematic review to clarify the associations of these specific ECG signs with the risk of syncope, sudden death, or equivalents in patients with BrS. The literature search identified 29 eligible articles comprising overall 5731 patients. The ECG findings associated with an incremental risk of syncope, sudden death, or equivalents (hazard ratio ranging from 1.1–39) were the following: localization of type 1 Brugada pattern (in V2 and peripheral leads), first‐degree atrioventricular block, atrial fibrillation, fragmented QRS, QRS duration >120 ms, R wave in lead aVR, S wave in L1 (≥40 ms, amplitude ≥0.1 mV, area ≥1 mm2), early repolarization pattern in inferolateral leads, ST‐segment depression, T‐wave alternans, dispersion of repolarization, and Tzou criteria. Conclusions At least 12 features of standard ECG are associated with a higher risk of sudden death in BrS. A multiparametric risk assessment approach based on ECG parameters associated with clinical and genetic findings could help improve current risk stratification scores of patients with BrS and warrants further investigation. Registration URL: https://www.crd.york.ac.uk/prospero/. Unique identifier: CRD42019123794.https://www.ahajournals.org/doi/10.1161/JAHA.121.020767arrhythmiasarrhythmic risk stratificationBrugada syndromeelectrocardiogram |
| spellingShingle | Francesco Vitali Alessandro Brieda Cristina Balla Rita Pavasini Elisabetta Tonet Matteo Serenelli Roberto Ferrari Pietro Delise Claudio Rapezzi Matteo Bertini Standard ECG in Brugada Syndrome as a Marker of Prognosis: From Risk Stratification to Pathophysiological Insights Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease arrhythmias arrhythmic risk stratification Brugada syndrome electrocardiogram |
| title | Standard ECG in Brugada Syndrome as a Marker of Prognosis: From Risk Stratification to Pathophysiological Insights |
| title_full | Standard ECG in Brugada Syndrome as a Marker of Prognosis: From Risk Stratification to Pathophysiological Insights |
| title_fullStr | Standard ECG in Brugada Syndrome as a Marker of Prognosis: From Risk Stratification to Pathophysiological Insights |
| title_full_unstemmed | Standard ECG in Brugada Syndrome as a Marker of Prognosis: From Risk Stratification to Pathophysiological Insights |
| title_short | Standard ECG in Brugada Syndrome as a Marker of Prognosis: From Risk Stratification to Pathophysiological Insights |
| title_sort | standard ecg in brugada syndrome as a marker of prognosis from risk stratification to pathophysiological insights |
| topic | arrhythmias arrhythmic risk stratification Brugada syndrome electrocardiogram |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.020767 |
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