Arrhythmias & electrophysiology
Left Ventricular Abnormal Substrate in Brugada Syndrome
Authors' conclusion
A subset of patients with BrS present an abnormal substrate extending onto the LV epicardium and inferior RV that is associated with SCN5A mutations and multigenic variants.
Study context
- Population
- Patients with Brugada syndrome referred for recurrent ventricular arrhythmias21 male
- Participants
- 22 patients
- Comparison
- Patients with left ventricle (LV) epicardial substrate vs without
- LV substraten = 10
- Outcome
- Extent of epicardial abnormal substrate (prolonged >70 ms fragmented electrograms)
Methodological detailsconsecutive patients, high-density biventricular epicardial mapping
- Consecutive patients
- High-density biventricular epicardial mapping
Main finding
As reported in the abstract
Abnormal epicardial substrate
- Abnormal substrate in epicardial anterior right ventricle (RV), all patients (area, cm², mean ± SD)
- 27 ± 11 cm²
- Abnormal substrate on LV epicardium
- 10 patients (45%)
- LV substrate at baseline / after ajmaline
- 9 / 1
- LV substrate area
- 15 ± 11 cm²
- Severe LV fascicular blocks among patients with LV substrate
- 4
Further findings
Arrhythmia history duration
P = 0.003
PR interval
P < 0.001
HV interval
P = 0.005
Substrate extending into inferior RV
P = 0.001
SCN5A mutation
P = 0.035
| Outcome | Median of differences (95% CI) | P value | |
|---|---|---|---|
| Polygenic risk score, SCN5A BrS patients with recurrent ventricular arrhythmiasvs nonselected BrS populationHigher polygenic risk score | −0.86 (−1.48 to −0.27) | P = 0.02 | |
| −2−101Difference (linear scale) |
Original publication
Left Ventricular Abnormal Substrate in Brugada Syndrome. JACC Clin Electrophysiol. Published 19 July 2023. doi:10.
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