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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Number of electrocardiogram leads displaying the diagnostic coved-type pattern in Brugada syndrome: a diagnostic

Sergio Richter1, Andrea Sarkozy, Gaetano Paparella

  • 1Heart Rhythm Management Centre, Cardiovascular Centre, Free University of Brussels (UZ Brussel) VUB, Laarbeeklaan 101, Brussels 1090, Belgium.

European Heart Journal
|March 18, 2010
PubMed

Insights

Brugada syndrome diagnosis may not require multiple right precordial leads (RPLs). One diagnostic RPL on ECG is sufficient, as lead V3 offers no diagnostic value. Revision of consensus criteria is suggested.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Diagnostics

Background:

  • Brugada syndrome diagnosis relies on electrocardiogram (ECG) criteria using right precordial leads (RPLs).
  • Current consensus requires coved-type ST-segment elevation in at least two RPLs (V1-V3).
  • The diagnostic utility of specific RPLs and the necessity of multiple leads remain unevaluated.

Purpose of the Study:

  • To assess the distribution of coved-type ST-segment elevation in RPLs in a large patient cohort.
  • To reevaluate the appropriateness of current diagnostic consensus criteria for Brugada syndrome.

Main Methods:

  • Analysis of 376 ECGs from 186 individuals with spontaneous or drug-induced Brugada syndrome patterns.
  • Evaluation of the number, distribution, and maximal J-point elevation of diagnostic RPLs (V1-V3).

Main Results:

  • 38% of ECGs showed diagnostic ST-segment elevation in only one RPL; 7% in three RPLs; 55% in two RPLs.
  • Leads V1 and V2 were diagnostic in 99% of cases with two diagnostic RPLs; Lead V3 was not diagnostic alone.
  • Patients with one diagnostic RPL had similar clinical profiles and arrhythmic risk (8% major events over 5 years) compared to those with multiple diagnostic RPLs.

Conclusions:

  • Lead V3 does not provide diagnostic information for Brugada syndrome.
  • ECGs with a single diagnostic RPL are sufficient for Brugada syndrome diagnosis.
  • Current consensus criteria for Brugada syndrome require revision.
Abstract

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