Characteristics of patients with Brugada syndrome and monomorphic ventricular tachycardia.
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Monaco Cinzia, Benali Karim, Cespon-Fernandez Maria, Bouteiller Xavier, Del Monte Alvise, Pannone Luigi, Surget Elodie, Mascia Giuseppe, Notarstefano Pasquale, Menè Roberto, Kneizeh Kinan, Yokoyama Masaaki, Arnaud Marine, Vlachos Konstantinos, Nakasone Kazutaka, Verhaeghe Laurens, Fitzgerald John L, Plant Allan, Della Rocca Domenico, Cathala Aude, Samson Sophie, Sieira Juan, Tixier Romain, Duchateau Josselin, Pambrun Thomas, Conte Giulio, Chierchia Gian Battista, Hocini Meleze, Porto Italo, Derval Nicolas, Mazzone Patrizio, Sacher Frederic, Jaïs Pierre, Brugada Pedro, de Asmundis Carlo, Haïssaguerre Michel, Bordeaux Electrophysiology Investigators
Аннотация
OBJECTIVE: This study aimed to evaluate the characteristics of patients with BrS presenting with MVT compared with those with VF.
METHODS: We performed a retrospective multicenter study of patients with BrS who received an implantable cardioverter-defibrillator (ICD). Inclusion criteria were (1) the initiation of ventricular arrhythmia on ICD recordings and (2) the absence of antiarrhythmic drugs or previous ventricular ablation. Arrhythmic events were classified as MVT or polymorphic ventricular tachycardia (PVT)/VF (both referred to as VF) according to the guidelines. We analyzed clinical data, characteristics related to arrhythmia initiation, and electroanatomic substrate.
RESULTS: Among 793 patients with BrS with ICDs (44.2 ± 17.7 years, 37.1% women), 54 met the inclusion criteria. ICD recordings showed a total of 47 VF episodes and 27 MVT episodes, overlapping in only 1 patient. Patients with MVT were older at first event (47.7 ± 13.4 vs 40.7 ± 12.6 years, P = .06), had higher QRS duration, more prevalence of syncope, and later recurrences after ICD implantation (median 51 vs 20 months, P = .018). Rapid rhythms (>100 beats/min) were more frequent before MVT than VF (48.1% vs 8.5%, P < .001) with a lower incidence of ectopy (22.2% vs 61.7, P = .001). Abnormal epicardial substrate was broader in patients with MVT in baseline conditions (11.3 ± 5.5 cm2 vs 6.8 ± 3.2 cm2, P = .006).
CONCLUSION: VF/PVT and MVT in patients with BrS have distinct clinical presentations. MVT shows a later onset compared with VF/PVT and is associated with a broader substrate area.