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Clarifying the arrhythmogenic substrate for Brugada syndrome
Masayoshi Kofune1, Ichiro Watanabe, Kimie Ohkubo
1Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
Brugada syndrome, a heart condition, is linked to the right ventricular outflow tract (RVOT). This study found structural abnormalities and slower electrical conduction in the RVOT of affected patients.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Electrophysiology
Background:
- Brugada syndrome is associated with the right ventricular outflow tract (RVOT), a key arrhythmogenic region.
- Understanding the electrical substrate of the RVOT is crucial for Brugada syndrome management.
Purpose of the Study:
- To investigate the electroanatomic characteristics of the right ventricle (RV) in patients with Brugada syndrome.
- To identify potential structural and electrical abnormalities in the RVOT contributing to Brugada syndrome.
Main Methods:
- Electroanatomic mapping of the right ventricle (RV) using the CARTO system.
- Comparison between 11 asymptomatic Brugada syndrome patients (with inducible ventricular fibrillation) and 5 control patients.
Main Results:
- Patients with Brugada syndrome exhibited a significantly larger low voltage zone area (< 1.5 mV) in the RVOT (16.1% vs. 7.8%).
- Bipolar electrogram duration was significantly prolonged in Brugada syndrome patients (81.6 ms vs. 53.4 ms), particularly in the RVOT septal portion and free wall.
Conclusions:
- The findings suggest the presence of regional endocardial conduction slowing in the RVOT of Brugada syndrome patients.
- Structural abnormalities in the RVOT likely underlie the observed conduction slowing and arrhythmogenesis in Brugada syndrome.
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