Progressive increase in activation delay during premature stimulation is related to ventricular fibrillation in Brugada syndrome

• Published in: Journal of cardiovascular electrophysiology 2021-07, Vol.32 (7), p.1939-1946
• Main Authors: Hasegawa, Yuki, Izumi, Daisuke, Ikami, Yasuhiro, Otsuki, Sou, Yagihara, Nobue, Iijima, Kenichi, Chinushi, Masaomi, Minamino, Tohru
• Format: Article
• Language: English
• Subjects: activation delay; Brugada syndrome; Cardiac arrhythmia; Conduction; Defibrillators; EKG; electrophysiologic study; Electrophysiological recording; Fibrillation; Heart; premature stimulation; Risk factors; Ventricle; ventricular fibrillation
• ISSN: 1045-3873; 1540-8167
• DOI: 10.1111/jce.15065

Introduction The local conduction delay has been deemed to play an important role in the perpetuation of ventricular fibrillation (VF) in Brugada syndrome (BrS). We evaluated the relationship between the activation delay during programmed stimulation and cardiac events in BrS patients. Methods This study included 47 consecutive BrS patients who underwent an electrophysiological study and received implantable cardiac defibrillator therapy. We divided the patients into two groups based on whether they had developed VF (11 patients) or not (36 patients) during the follow‐up period of 89 ± 53 months. The activation delay was assessed using the interval between the stimulus and the QRS onset during programmed stimulation. The mean increase in delay (MID) was used to characterize the conduction curves. Results The MID at the right ventricular outflow tract (RVOT) was significantly greater in patients with VF (4.5 ± 1.2 ms) than in those without VF (2.2 ± 0.9 ms) (p