Tpeak-Tend interval and Tpeak-Tend/QT ratio as markers of ventricular tachycardia inducibility in subjects with Brugada ECG phenotype

Europace. 2010 Feb;12(2):271-4. doi: 10.1093/europace/eup357. Epub 2009 Nov 6.

Abstract

Aims: The present study investigated whether several ECG markers of ventricular repolarization are associated with ventricular tachycardia/fibrillation (VT/VF) inducibility in subjects with type 1 ECG pattern of Brugada syndrome (BS).

Methods and results: The clinical data of 23 individuals (19 males, age 42.69 +/- 14.63) with spontaneous (n = 10) or drug-induced (n = 13) type 1 ECG pattern of BS who underwent programmed ventricular stimulation were analysed. Sustained VT/VF was induced in 17 subjects (74%) and was significantly associated with the presence of spontaneous type 1 ECG of BS (P = 0.012). Among the studied ECG repolarization markers, subjects with inducible VT/VF displayed an increased T(peak)-T(end) interval in leads V(2) (88.82 +/- 15.70 vs. 78.33 +/- 4.08 ms, P = 0.02) and V(6) (76.33 +/- 10.08 vs. 66.66 +/- 5.16 ms, P = 0.04) and a greater T(peak)-T(end)/QT ratio in lead V(6) (0.214 +/- 0.028 vs. 0.180 +/- 0.014, P = 0.009) compared with those without arrhythmias. Ventricular tachycardia/fibrillation inducibility was not associated with arrhythmic events during a mean follow-up period of 4.61 +/- 2.14 years (P = 0.739).

Conclusion: The T(peak)-T(end) interval and T(peak)-T(end)/QT ratio were associated with VT/VF inducibility in BS. The utility of T(peak)-T(end)/QT ratio as a new marker of arrhythmogenesis in BS requires further studies, including a large number of patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Ajmaline / adverse effects
  • Anti-Arrhythmia Agents / adverse effects
  • Biomarkers
  • Brugada Syndrome / chemically induced
  • Brugada Syndrome / physiopathology*
  • Electrocardiography*
  • Female
  • Flecainide / adverse effects
  • Heart Conduction System / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Retrospective Studies
  • Risk Factors
  • Tachycardia, Ventricular / epidemiology*
  • Tachycardia, Ventricular / physiopathology*
  • Ventricular Fibrillation / epidemiology
  • Ventricular Fibrillation / physiopathology

Substances

  • Anti-Arrhythmia Agents
  • Biomarkers
  • Ajmaline
  • Flecainide