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Sinus node function in patients with Brugada-type ECG
Hiroshi Morita1, Kengo Fukushima-Kusano, Satoshi Nagase
1Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Okayama, Japan. hmorita@cc.okayama-u.ac.jp
Summary
Patients with Brugada syndrome (BS) experiencing ventricular fibrillation (VF) show impaired sinus node and atrioventricular (AV) node function. This study evaluated cardiac electrophysiology in BS patients, revealing significant conduction disturbances.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Electrophysiology
Background:
- Brugada syndrome (BS) is associated with atrioventricular conduction disturbances.
- Sinus node function in BS patients has not been previously evaluated.
Purpose of the Study:
- To evaluate sinus node and atrioventricular (AV) node function in Brugada syndrome (BS) patients.
- To compare electrophysiological parameters between BS patients with and without induced ventricular fibrillation (VF).
Main Methods:
- Programmed electrical stimulation (PES) was performed on 60 BS patients.
- Patients were categorized into a VF group (n=26) and a non-VF group (n=34) based on PES results.
- Sinus node recovery time, sino-atrial conduction time, and His-ventricle interval were assessed.
Main Results:
- Sinus node function was attenuated in the VF group (corrected sinus node recovery time: 452±126 ms) compared to the non-VF group (324±146 ms).
- Sino-atrial conduction time was prolonged in the VF group (179±60 ms) versus the non-VF group (127±60 ms).
- The His-ventricle interval was significantly prolonged in the VF group (41±9 ms) compared to the non-VF group (35±8 ms).
Conclusions:
- Both sinus node and AV node function are attenuated in Brugada syndrome patients who experience inducible ventricular fibrillation via PES.
- These findings suggest a broader role of conduction system disease in the pathophysiology of Brugada syndrome, particularly in those with a higher risk of ventricular arrhythmias.