COMPLETE RBBB PATTERN IN ECGS IN PATIENTS WITHBRUGADA SYNDROME IS ASSOCIATED WITH A HIGHERINCIDENCE OF VENTRICULAR FIBRILLATION EVENTS

摘要

ECGs in 32 patients with Brugada syndrome (male 32, mean age 52+-17 years old) were analyzed before (baseline) and after application of pilsicainide (37-75mg, i.v.). The diagnosis of the syndrome was made on the basis of Brugada type ECG pattern, episodes of syncope and/or induction of ventricular fibrillation (VF) by premature stimulation with progressively short coupling intervals. Of 32 patients, coved-type ECG with a J-point elevation of =0.2mV was observed in 8 patients at baseline and 21 patients after pilsicainide. Complete right bundle branch block (CRBBB) pattern was observed in 4 patients at baseline and 10 patients after pilsicainide. Twenty two patients were treated with implantable cardioverter-defibrillator (ICD). During a mean follow-up of 24.7+-17.2 months, 6 patients (27%) received defibrillation shocks. The Kaplan-Meier analysis of arrhythmic events during the follow-up period revealed that CRBBB (either in the absence or presence of plisicainde) was associated with a higher incidence of VF events. Six (67%) of 9 patients with CRBBB pattern experienced VF, whereas no VF events were documented in 13 patients without CRBBB. Conclusion CRBBB pattern may be a useful ECG sign in risk stratification of Brugada syndrome for VF events.