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Yield of 12-lead 24-hour ambulatory ECG monitoring in the identification of a spontaneous type 1 Brugada pattern and its prognostic value. A sub-study of the BHF RASE Brugada project

European journal of arrhythmia & electrophysiology, 2022-01, Vol.8, p.2 [Peer Reviewed Journal]

2022. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the associated terms available at https://www.touchcardio.com/cardio-journals ;ISSN: 2058-3869 ;EISSN: 2058-3877

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  • Title:
    Yield of 12-lead 24-hour ambulatory ECG monitoring in the identification of a spontaneous type 1 Brugada pattern and its prognostic value. A sub-study of the BHF RASE Brugada project
  • Author: Scrocco, C ; Ben-Haim, Y ; Miles, C ; Specterman, M ; Tome-Esteban, M ; Papadakis, M ; Sharma, S ; Behr, E R
  • Subjects: Electrocardiography
  • Is Part Of: European journal of arrhythmia & electrophysiology, 2022-01, Vol.8, p.2
  • Description: Background: A type 1 Brugada pattern (T1-BrS) is a recognised marker of arrhythmic risk. Twelve-lead 24-hour Holter monitoring with V1 and V2 in standard and high precordial electrocardiogram (ECG) lead (HPL) positions, can identify transient spontaneous T1-BrS pattern in BrS patients with a concealed T1-BrS at presentation. Aim: To investigate the yield and prognostic value of 12-lead 24-hour Holter monitoring with additional high precordial ECG leads (HPL-Holter) in a large single-centre cohort of BrS patients. Methods: A total of 278 subjects with BrS (56% male, mean age at presentation 43 ± 15 years) were included in this study, for whom complete clinical and follow-up data and HPL-Holter(s) after initial evaluation were available. Of these, 59 had a spontaneous T1-BrS pattern at presentation (Group 1) and 219 did not (Group 2), usually requiring ajmaline provocation testing to confirm the diagnosis. Results: From 2008 to 2022, 552 HPL-Holters were recorded in the study cohort (median 2, range 1–6). In total, 43 (73%) subjects in Group 1 and 32 (15%) in Group 2 showed a T1-BrS pattern during HPL-Holter monitoring at least once; this was evident on the 1st follow-up recording in 95% of cases in Group 1 and 66% in Group 2 (median 10 months, IQR 45, range 0.5–64), with at least 2 recordings needed in 28% of subjects in this latter group. Patients with a newly identified T1-BrS in Group 2 tended to be older (mean age 48 ± 14 vs 42 ± 16 years; p=0.05) and to carry the proband status (56% vs 52%; p<0.05) than those without, whereas there were no significant differences in gender, family history of sudden cardiac death and the presence of previous symptoms. Over a median follow-up of 68 months (IQR 64), significant arrhythmic events (appropriate ICD shocks on VT/VF) occurred in 2 subjects in Group 1 (1/43 showing T1-BrS during HPL-Holter monitoring and 1/16 not showing it; p=NS) and in 4 subjects in Group 2 (2/32 with newly identified spontaneous T1-BrS and 2/187 without; p<0.05). Conclusions: Twelve-lead 24-hour ambulatory ECG monitoring including additional HPLs can identify a transient spontaneous T1-BrS in up to 15% of the subjects without the diagnostic pattern at presentation, most during the first year after the diagnosis. In this group, the presence of a T1-BrS pattern is associated with arrhythmic events. We recommend re-evaluation with high precordial 12-lead Holter monitoring of subjects without spontaneous T1-BrS at presentation once a year for at least the first 2 years post-diagnosis. ❑ [Image Omitted]
  • Publisher: Reading: Touch Medical Media Limited
  • Language: English
  • Identifier: ISSN: 2058-3869
    EISSN: 2058-3877
  • Source: Alma/SFX Local Collection
    ProQuest Central
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