Could specific EKG markers identify a pharmacologically induced type 1 Brugada pattern? Insights from a large, single-centre cohort in Europace
2021
ASL Vercelli
Tipo pubblicazione
Conference Abstract
Autori/Collaboratori (8)Vedi tutti...
Rametta F
Occhetta E
Malacrida M
et alii...
Abstract
Background. Pharmacological (Ajmaline) induction of a type 1 Brugada pattern is currently considered mandatory for the diagnosis of Brugada syndrome. However, performing the test requires time and healthcare resources. Some EKG markers have been proposed as predictors of positive result at Ajmaline test. Aim. To evaluate in a large population the predictive value of multiple EKG markers for Ajmaline test results. Methods. We retrospectively analysed consecutive patients (pts) referred to our Centre to perform Ajmaline test. All pts had type 2 Brugada pattern detected at a conventional EKG or were relatives of pts with positive Ajmaline test, with or without type 2 Brugada pattern at EKG. All pts performed the Ajmaline pharmacological test (1 mg/Kg iv) with EKG “superior” right precordial unipolar derivations monitoring. To determine whether clinical parameters (age, gender, cardiomyopathy, history of arrhythmias, symptoms, familiarity) and EKG markers (heart rate (HR), PR duration, R1V1 and SV6 duration and amplitude, QRSV1/QRSV6 duration, V1 and V2 ST amplitude (coved or saddle back pattern) were independently associated to positivity at Ajmaline test, a logistic regression model was applied. Results. From January 2010 to December 2019 we evaluated 442 consecutive pts: mean age 40.1 ± 14.5 years; 273 (65%) male; 352 (80%) pts were included because of type 2 Brugada pattern at EKG and 90 (20%) for familial screening. The Ajmaline test was positive in 150 (34%) pts. At multivariate logistic regression analysis adjusted for baseline confounders, age > 45 years (OR= 1.64, 95%CI: 1.03 to 2.54; p = 0.0385), female gender (OR = 1.79, 95%CI: 1.12 to 2.85; p = 0.0141), HR > 60 bpm (OR = 2.44, 95%CI: 1.48 to 4.03; p = 0.0005), QRSV1/ QRSV6 duration (msec) >1 (OR = 5.34, 95%CI: 3.28 to 8.69; p < 0.0001) and non isoelectric pattern (coved/saddle back) in V2 (OR = 1.93, 95%CI: 1.03 to 3.63, p = 0.0416) remained associated with a positive Ajmaline test. The percentag
DOI : 10.1093/europace/euab116.011
Keywords
male; predictive value; major clinical study; heart rate; human; lordosis; heart arrhythmia; gender; genetic susceptibility; female; electrocardiogram; drug therapy; drug combination; controlled study; confounding variable; conference abstract; clinical evaluation; relative; cardiomyopathy; adult; ajmaline; retrospective study; risk assessment;