RT, RTend and Tpeak-End Intervalby Signal-Averaged Vector 187 Channel High Resolution ECG for Risk Stratification of Brugada Syndrome

Abstract

Spatial and transmural dispersion of refractoriness have been reported to relate to arrhythmogenesis of Brugada syndrome (BS). Recovery time (RT), RTend and Tpeak-end (Tp-e) was evaluated in Brugada syndrome (BS). The synthesized signals from vector-projected 187-channel ECGs were amplified. Maximum inter-lead difference, mean inter-lead difference of RT, max. and avg. RT, max. and avg. RTend, max. and avg. Tp-e interval, and late potential by vector magnitude ECG were compared were studied in 27 spontaneous type 1 ECG and 14 non-type 1 BS patients. There were no significant differences in max. and avg. RTend interval, max. Tp-e interval, and avg. RT between type 1 and non-type 1 patients. But max. RT was marginally longer in type 1 patients (86.3±20.8 vs. 73.7±20.9 ms, P=0.07). No relation was found between max. and avg. RT and RTend, and max. Tpeak-end to the symptom. However, avg. Tp-e interval was significantly longer in patients with than that in patients without symptom (41.1±15.2 ms vs. 27.6±13.7 ms, P=0.028). Late potentials were positive in 87.5% (7/8) in 8 patients with symptom, and in 50% (16/32) in patients without symptom P=0.1074). Conclusions: Spatial dispersion of repolarization may relate to the typical ECG manifestation of BS and not spatial and transmural dispersion of repolarization but conduction disturbance may relate to the arrhythmic events.