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Time-Domain T-Wave Alternans is Strongly Associated with a History of Ventricular Fibrillation in Patients with Brugada Syndrome
Time‐Domain T‐Wave Alternans and Brugada Syndrome Aims T‐wave alternans (TWA) is an indicator of vulnerability to ventricular arrhythmias and is useful for predicting sudden cardiac death (SCD) in patients with various structural heart diseases. We evaluated whether high levels of time‐domain TWA on...
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Published in: | Journal of cardiovascular electrophysiology 2014-09, Vol.25 (9), p.1021-1027 |
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container_title | Journal of cardiovascular electrophysiology |
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creator | UCHIMURA-MAKITA, YUKO NAKANO, YUKIKO TOKUYAMA, TAKEHITO FUJIWARA, MAI WATANABE, YOSHIKAZU SAIRAKU, AKINORI KAWAZOE, HIROSHI MATSUMURA, HIROYA ODA, NOZOMU IKANAGA, HIROKI MOTODA, CHIKAAKI KAJIHARA, KENTA ODA, NOBORU VERRIER, RICHARD L. KIHARA, YASUKI |
description | Time‐Domain T‐Wave Alternans and Brugada Syndrome
Aims
T‐wave alternans (TWA) is an indicator of vulnerability to ventricular arrhythmias and is useful for predicting sudden cardiac death (SCD) in patients with various structural heart diseases. We evaluated whether high levels of time‐domain TWA on ambulatory ECG (AECG) are associated with a history of ventricular fibrillation (VF) in Brugada syndrome (BrS) patients.
Methods and Results
We examined the associations among VF history, family history of SCD, spontaneous type 1 electrocardiogram (ECG), late potentials, VF induction by programmed electrical stimulation, and TWA in 45 BrS patients (44 males; mean age, 45 ± 15 years). TWA analyzed from 24‐h AECG recordings using the modified moving average method was positive in 13 of 43 patients (30%). Patients with a history of VF had a significantly higher incidence of a positive TWA test (82% vs. 13%; P < 0.001) and spontaneous type 1 ECG (92% vs. 38%; P = 0.007) than those without VF history. Multivariate analysis indicated that positive TWA (OR 7.217; 95% CI 2.503–35.504; P = 0.002) and spontaneous type 1 ECG (OR 5.530; 95% CI 1.651–34.337; P = 0.020) were closely associated with VF history. Spontaneous type 1 ECG had high sensitivity (92%) but low specificity (63%). Positive TWA was a reliable marker with high sensitivity and specificity (82% and 88%, respectively).
Conclusion
Elevated time‐domain TWA on AECG confirms arrhythmia risk in symptomatic BrS patients without the need for provocative stimuli. |
doi_str_mv | 10.1111/jce.12441 |
format | article |
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Aims
T‐wave alternans (TWA) is an indicator of vulnerability to ventricular arrhythmias and is useful for predicting sudden cardiac death (SCD) in patients with various structural heart diseases. We evaluated whether high levels of time‐domain TWA on ambulatory ECG (AECG) are associated with a history of ventricular fibrillation (VF) in Brugada syndrome (BrS) patients.
Methods and Results
We examined the associations among VF history, family history of SCD, spontaneous type 1 electrocardiogram (ECG), late potentials, VF induction by programmed electrical stimulation, and TWA in 45 BrS patients (44 males; mean age, 45 ± 15 years). TWA analyzed from 24‐h AECG recordings using the modified moving average method was positive in 13 of 43 patients (30%). Patients with a history of VF had a significantly higher incidence of a positive TWA test (82% vs. 13%; P < 0.001) and spontaneous type 1 ECG (92% vs. 38%; P = 0.007) than those without VF history. Multivariate analysis indicated that positive TWA (OR 7.217; 95% CI 2.503–35.504; P = 0.002) and spontaneous type 1 ECG (OR 5.530; 95% CI 1.651–34.337; P = 0.020) were closely associated with VF history. Spontaneous type 1 ECG had high sensitivity (92%) but low specificity (63%). Positive TWA was a reliable marker with high sensitivity and specificity (82% and 88%, respectively).
Conclusion
Elevated time‐domain TWA on AECG confirms arrhythmia risk in symptomatic BrS patients without the need for provocative stimuli.</description><identifier>ISSN: 1045-3873</identifier><identifier>EISSN: 1540-8167</identifier><identifier>DOI: 10.1111/jce.12441</identifier><identifier>PMID: 24761970</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>ambulatory monitoring ; Brugada syndrome ; Brugada Syndrome - complications ; Brugada Syndrome - physiopathology ; Electrocardiography, Ambulatory ; Female ; Humans ; implantable cardioverter-defibrillator ; Male ; Middle Aged ; Retrospective Studies ; sudden death ; T-wave alternans ; ventricular fibrillation ; Ventricular Fibrillation - etiology</subject><ispartof>Journal of cardiovascular electrophysiology, 2014-09, Vol.25 (9), p.1021-1027</ispartof><rights>2014 Wiley Periodicals, Inc.</rights><rights>Journal compilation © 2014 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5431-d45ea4abd79130f2ecc722a0d4bc8afdb49eb14362d060b6d3e266a5b4e0a2203</citedby><cites>FETCH-LOGICAL-c5431-d45ea4abd79130f2ecc722a0d4bc8afdb49eb14362d060b6d3e266a5b4e0a2203</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24761970$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>UCHIMURA-MAKITA, YUKO</creatorcontrib><creatorcontrib>NAKANO, YUKIKO</creatorcontrib><creatorcontrib>TOKUYAMA, TAKEHITO</creatorcontrib><creatorcontrib>FUJIWARA, MAI</creatorcontrib><creatorcontrib>WATANABE, YOSHIKAZU</creatorcontrib><creatorcontrib>SAIRAKU, AKINORI</creatorcontrib><creatorcontrib>KAWAZOE, HIROSHI</creatorcontrib><creatorcontrib>MATSUMURA, HIROYA</creatorcontrib><creatorcontrib>ODA, NOZOMU</creatorcontrib><creatorcontrib>IKANAGA, HIROKI</creatorcontrib><creatorcontrib>MOTODA, CHIKAAKI</creatorcontrib><creatorcontrib>KAJIHARA, KENTA</creatorcontrib><creatorcontrib>ODA, NOBORU</creatorcontrib><creatorcontrib>VERRIER, RICHARD L.</creatorcontrib><creatorcontrib>KIHARA, YASUKI</creatorcontrib><title>Time-Domain T-Wave Alternans is Strongly Associated with a History of Ventricular Fibrillation in Patients with Brugada Syndrome</title><title>Journal of cardiovascular electrophysiology</title><addtitle>J Cardiovasc Electrophysiol</addtitle><description>Time‐Domain T‐Wave Alternans and Brugada Syndrome
Aims
T‐wave alternans (TWA) is an indicator of vulnerability to ventricular arrhythmias and is useful for predicting sudden cardiac death (SCD) in patients with various structural heart diseases. We evaluated whether high levels of time‐domain TWA on ambulatory ECG (AECG) are associated with a history of ventricular fibrillation (VF) in Brugada syndrome (BrS) patients.
Methods and Results
We examined the associations among VF history, family history of SCD, spontaneous type 1 electrocardiogram (ECG), late potentials, VF induction by programmed electrical stimulation, and TWA in 45 BrS patients (44 males; mean age, 45 ± 15 years). TWA analyzed from 24‐h AECG recordings using the modified moving average method was positive in 13 of 43 patients (30%). Patients with a history of VF had a significantly higher incidence of a positive TWA test (82% vs. 13%; P < 0.001) and spontaneous type 1 ECG (92% vs. 38%; P = 0.007) than those without VF history. Multivariate analysis indicated that positive TWA (OR 7.217; 95% CI 2.503–35.504; P = 0.002) and spontaneous type 1 ECG (OR 5.530; 95% CI 1.651–34.337; P = 0.020) were closely associated with VF history. Spontaneous type 1 ECG had high sensitivity (92%) but low specificity (63%). Positive TWA was a reliable marker with high sensitivity and specificity (82% and 88%, respectively).
Conclusion
Elevated time‐domain TWA on AECG confirms arrhythmia risk in symptomatic BrS patients without the need for provocative stimuli.</description><subject>ambulatory monitoring</subject><subject>Brugada syndrome</subject><subject>Brugada Syndrome - complications</subject><subject>Brugada Syndrome - physiopathology</subject><subject>Electrocardiography, Ambulatory</subject><subject>Female</subject><subject>Humans</subject><subject>implantable cardioverter-defibrillator</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>sudden death</subject><subject>T-wave alternans</subject><subject>ventricular fibrillation</subject><subject>Ventricular Fibrillation - etiology</subject><issn>1045-3873</issn><issn>1540-8167</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><recordid>eNp1kc1u1DAUhSMEoqWw4AWQJTawSOt_J8vptNOChh-pA7O0nPimeEjiYidts-PRcUnbBRLe-Er-zqcrnyx7TfAhSedoV8MhoZyTJ9k-ERznBZHqaZoxFzkrFNvLXsS4w5gwicXzbI9yJUmp8H72e-M6yE98Z1yPNvnWXANatAOE3vQRuYguhuD7y3ZCixh97cwAFt244Qcy6NzFwYcJ-QZ9h34Irh5bE9DKVcG1rRmc71Gyfk1Teo5z7DiMl8YadDH1NvgOXmbPGtNGeHV_H2TfVqeb5Xm-_nL2YblY57XgjOSWCzDcVFaVhOGGQl0rSg22vKoL09iKl1ARziS1WOJKWgZUSiMqDthQitlB9m72XgX_a4Q46M7FGtKePfgxaiIkwSkuRULf_oPu_Jg-pL2jRFlISlWRqPczVQcfY4BGXwXXmTBpgvVdLTrVov_Wktg398ax6sA-kg89JOBoBm5cC9P_Tfrj8vRBmc-JVALcPiZM-KmlYkro7ecz_elkvSqPt4Vesj92fKZf</recordid><startdate>201409</startdate><enddate>201409</enddate><creator>UCHIMURA-MAKITA, YUKO</creator><creator>NAKANO, YUKIKO</creator><creator>TOKUYAMA, TAKEHITO</creator><creator>FUJIWARA, MAI</creator><creator>WATANABE, YOSHIKAZU</creator><creator>SAIRAKU, AKINORI</creator><creator>KAWAZOE, HIROSHI</creator><creator>MATSUMURA, HIROYA</creator><creator>ODA, NOZOMU</creator><creator>IKANAGA, HIROKI</creator><creator>MOTODA, CHIKAAKI</creator><creator>KAJIHARA, KENTA</creator><creator>ODA, NOBORU</creator><creator>VERRIER, RICHARD L.</creator><creator>KIHARA, YASUKI</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201409</creationdate><title>Time-Domain T-Wave Alternans is Strongly Associated with a History of Ventricular Fibrillation in Patients with Brugada Syndrome</title><author>UCHIMURA-MAKITA, YUKO ; NAKANO, YUKIKO ; TOKUYAMA, TAKEHITO ; FUJIWARA, MAI ; WATANABE, YOSHIKAZU ; SAIRAKU, AKINORI ; KAWAZOE, HIROSHI ; MATSUMURA, HIROYA ; ODA, NOZOMU ; IKANAGA, HIROKI ; MOTODA, CHIKAAKI ; KAJIHARA, KENTA ; ODA, NOBORU ; VERRIER, RICHARD L. ; KIHARA, YASUKI</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5431-d45ea4abd79130f2ecc722a0d4bc8afdb49eb14362d060b6d3e266a5b4e0a2203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>ambulatory monitoring</topic><topic>Brugada syndrome</topic><topic>Brugada Syndrome - complications</topic><topic>Brugada Syndrome - physiopathology</topic><topic>Electrocardiography, Ambulatory</topic><topic>Female</topic><topic>Humans</topic><topic>implantable cardioverter-defibrillator</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>sudden death</topic><topic>T-wave alternans</topic><topic>ventricular fibrillation</topic><topic>Ventricular Fibrillation - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>UCHIMURA-MAKITA, YUKO</creatorcontrib><creatorcontrib>NAKANO, YUKIKO</creatorcontrib><creatorcontrib>TOKUYAMA, TAKEHITO</creatorcontrib><creatorcontrib>FUJIWARA, MAI</creatorcontrib><creatorcontrib>WATANABE, YOSHIKAZU</creatorcontrib><creatorcontrib>SAIRAKU, AKINORI</creatorcontrib><creatorcontrib>KAWAZOE, HIROSHI</creatorcontrib><creatorcontrib>MATSUMURA, HIROYA</creatorcontrib><creatorcontrib>ODA, NOZOMU</creatorcontrib><creatorcontrib>IKANAGA, HIROKI</creatorcontrib><creatorcontrib>MOTODA, CHIKAAKI</creatorcontrib><creatorcontrib>KAJIHARA, KENTA</creatorcontrib><creatorcontrib>ODA, NOBORU</creatorcontrib><creatorcontrib>VERRIER, RICHARD L.</creatorcontrib><creatorcontrib>KIHARA, YASUKI</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiovascular electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>UCHIMURA-MAKITA, YUKO</au><au>NAKANO, YUKIKO</au><au>TOKUYAMA, TAKEHITO</au><au>FUJIWARA, MAI</au><au>WATANABE, YOSHIKAZU</au><au>SAIRAKU, AKINORI</au><au>KAWAZOE, HIROSHI</au><au>MATSUMURA, HIROYA</au><au>ODA, NOZOMU</au><au>IKANAGA, HIROKI</au><au>MOTODA, CHIKAAKI</au><au>KAJIHARA, KENTA</au><au>ODA, NOBORU</au><au>VERRIER, RICHARD L.</au><au>KIHARA, YASUKI</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Time-Domain T-Wave Alternans is Strongly Associated with a History of Ventricular Fibrillation in Patients with Brugada Syndrome</atitle><jtitle>Journal of cardiovascular electrophysiology</jtitle><addtitle>J Cardiovasc Electrophysiol</addtitle><date>2014-09</date><risdate>2014</risdate><volume>25</volume><issue>9</issue><spage>1021</spage><epage>1027</epage><pages>1021-1027</pages><issn>1045-3873</issn><eissn>1540-8167</eissn><abstract>Time‐Domain T‐Wave Alternans and Brugada Syndrome
Aims
T‐wave alternans (TWA) is an indicator of vulnerability to ventricular arrhythmias and is useful for predicting sudden cardiac death (SCD) in patients with various structural heart diseases. We evaluated whether high levels of time‐domain TWA on ambulatory ECG (AECG) are associated with a history of ventricular fibrillation (VF) in Brugada syndrome (BrS) patients.
Methods and Results
We examined the associations among VF history, family history of SCD, spontaneous type 1 electrocardiogram (ECG), late potentials, VF induction by programmed electrical stimulation, and TWA in 45 BrS patients (44 males; mean age, 45 ± 15 years). TWA analyzed from 24‐h AECG recordings using the modified moving average method was positive in 13 of 43 patients (30%). Patients with a history of VF had a significantly higher incidence of a positive TWA test (82% vs. 13%; P < 0.001) and spontaneous type 1 ECG (92% vs. 38%; P = 0.007) than those without VF history. Multivariate analysis indicated that positive TWA (OR 7.217; 95% CI 2.503–35.504; P = 0.002) and spontaneous type 1 ECG (OR 5.530; 95% CI 1.651–34.337; P = 0.020) were closely associated with VF history. Spontaneous type 1 ECG had high sensitivity (92%) but low specificity (63%). Positive TWA was a reliable marker with high sensitivity and specificity (82% and 88%, respectively).
Conclusion
Elevated time‐domain TWA on AECG confirms arrhythmia risk in symptomatic BrS patients without the need for provocative stimuli.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>24761970</pmid><doi>10.1111/jce.12441</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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language | eng |
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source | Wiley-Blackwell Read & Publish Collection |
subjects | ambulatory monitoring Brugada syndrome Brugada Syndrome - complications Brugada Syndrome - physiopathology Electrocardiography, Ambulatory Female Humans implantable cardioverter-defibrillator Male Middle Aged Retrospective Studies sudden death T-wave alternans ventricular fibrillation Ventricular Fibrillation - etiology |
title | Time-Domain T-Wave Alternans is Strongly Associated with a History of Ventricular Fibrillation in Patients with Brugada Syndrome |
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