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- Title
Increased Intraatrial Conduction Abnormality Assessed by P-Wave Signal-Averaged Electrocardiogram in Patients with Brugada Syndrome.
- Authors
FURUKAWA, YOSHIO; YAMADA, TAKAHISA; OKUYAMA, YUJI; MORITA, TAKASHI; TANAKA, KOJI; IWASAKI, YUSUKE; UEDA, HIROMICHI; OKADA, TAKESHI; KAWASAKI, MASATO; KURAMOTO, YUKI; FUKUNAMI, MASATAKE
- Abstract
Background: Atrial fibrillation (AF) is observed in patients with Brugada syndrome (BS), especially those showing coved-type electrocardiogram (ECG) pattern. Using P-wave signal-averaged ECG (P-SAE), we investigated whether increased intraatrial conduction abnormality contributed to AF generation in BS patients. Methods: Twenty BS patients and 20 age- and gender-matched healthy controls were enrolled. At the P-SAE recording, 12 of the 20 BS patients showed coved-type (C-BS) and eight showed saddleback-type (S-BS). The total duration (Ad) and root mean square voltage for the terminal 20 ms (LP20) of the filtered P wave were measured. P-wave dispersion (P-disp) was defined as the difference between the maximum and minimum, measured from 16 precordial recording sites. Results: BS patients had a significantly longer Ad (128.2 ± 7.6 vs 116.3 ± 8.2 ms, P < 0.0001), lower LP20 (2.6 ± 0.9 vs 3.4 ± 0.8 μV, P < 0.01), and greater P-disp (15.5 ± 7.0 vs 7.4 ± 3.2 ms, P < 0.0001) than the controls. C-BS patients had significantly longer Ad (131.0 ± 7.2 vs 124.1 ± 6.8 ms, P < 0.05) and lower LP20 (2.2 ± 0.6 vs 3.2 ± 1.0 μV, P < 0.05) than S-BS patients. All C-BS patients and only three S-BS patients had atrial late potential (100% vs 38%, P < 0.01). Conclusion: Intraatrial conduction delay and its heterogeneity may exist in BS patients, especially those showing coved-type ECG patterns. These atrial electrical abnormalities could be a substrate for atrial reentrant tachycardia such as AF. (PACE 2011; 34:1138-1146)
- Subjects
ATRIAL fibrillation risk factors; ELECTROCARDIOGRAPHY; ANALYSIS of variance; CHI-squared test; ELECTROPHYSIOLOGY; HEART atrium; HEART conduction system; T-test (Statistics); BRUGADA syndrome
- Publication
Pacing & Clinical Electrophysiology, 2011, Vol 34, Issue 9, p1138
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/j.1540-8159.2011.03122.x