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01-06-2016 | Original Article

Utility of T-wave alternans during night time as a predictor for ventricular fibrillation in patients with Brugada syndrome

Authors: Shogo Sakamoto, Masahiko Takagi, Hiroaki Tatsumi, Atsushi Doi, Kenichi Sugioka, Akihisa Hanatani, Minoru Yoshiyama

Published in: Heart and Vessels | Issue 6/2016

Abstract

The prognostic value of T-wave alternans (TWA) during the night time in patients with Brugada syndrome (Br-S) remains unknown. We assessed TWA for risk stratification using 24-h multichannel Holter electrocardiogram (24-M-ECG) in Br-S. We enrolled 129 patients with Br-S [grouped according to histories of ventricular fibrillation (VF), n = 16; syncope, n = 10; or no symptoms (asymptomatic), n = 103] and 11 controls. Precordial electrodes were attached to the third (3L-V1, 3L-V2) and fourth (4L-V1, 4L-V2 and 4L-V5) intercostal spaces. We measured the values of maximum TWA (max-TWA) during the night time (12 a.m.–6 a.m.) and the day time (12 p.m.–6 p.m.) and calculated parameters of heart rate variability. Compared to the asymptomatic and control groups, the VF and syncope groups showed significantly greater 3L-V2 max-TWA during the night time. The cutoff value for the 3L-V2 max-TWA during the night time was determined as 20 µV (sensitivity 94 % and specificity 48 %; p = 0.01). Multivariate analysis revealed that 3L-V2 max-TWA during the night time ≥20 µV and previous VF episodes were independent predictors of future VF episodes. During a mean follow-up period of 68 ± 37 months, 16 patients experienced VF episodes. The incidence of VF episodes was the highest during the night time (p < 0.001). The 3L-V2 max-TWA during the night time may be a useful predictor for VF episodes in patients with Br-S.

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Title: Utility of T-wave alternans during night time as a predictor for ventricular fibrillation in patients with Brugada syndrome
Authors: Shogo Sakamoto
Masahiko Takagi
Hiroaki Tatsumi
Atsushi Doi
Kenichi Sugioka
Akihisa Hanatani
Minoru Yoshiyama
Publication date: 01-06-2016
Publisher: Springer Japan
Published in: Heart and Vessels / Issue 6/2016
Print ISSN: 0910-8327
Electronic ISSN: 1615-2573
DOI: https://doi.org/10.1007/s00380-015-0692-y

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