Electrical storm in patients with Brugada syndrome is associated with early repolarization

Yoshiaki Kaneko, Minoru Horie, Shinichi Niwano, Kengo F. Kusano, Seiji Takatsuki, Takashi Kurita, Takeshi Mitsuhashi, Tadashi Nakajima, Tadanobu Irie, Kanae Hasegawa, Takashi Noda, Shiro Kamakura, Yoshiyasu Aizawa, Ryobun Yasuoka, Katsumi Torigoe, Hiroshi Suzuki, Toru Ohe, Akihiko Shimizu, Keiichi Fukuda, Masahiko Kurabayashi & 1 others Yoshifusa Aizawa

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background: Electrical storms (ESs) in patients with Brugada syndrome (BrS) are rare though potentially lethal. Methods and Results: We studied 22 men with BrS and ES, defined as ≥3 episodes/d of ventricular fibrillation (VF) and compared their characteristics with those of 110 age-matched, control men with BrS without ES. BrS was diagnosed by a spontaneous or drug-induced type 1 pattern on the ECG in the absence of structural heart disease. Early repolarization (ER) was diagnosed by J waves, ie, >0.1 mV notches or slurs of the terminal portion of the QRS complex. The BrS ECG pattern was provoked with pilsicainide. A spontaneous type I ECG pattern, J waves, and horizontal/descending ST elevation were found, respectively, in 77%, 36%, and 88% of patients with ES, versus 28% (P<0.0001), 9% (P=0.003), and 60% (P=0.06) of controls. The J-wave amplitude was significantly higher in patients with than without ES (P=0.03). VF occurred during undisturbed sinus rhythm in 14 of 19 patients (74%), and ES were controlled by isoproterenol administration. All patients with ES received an implantable cardioverter defibrillator and over a 6.0±5.4 years followup, the prognosis of patients with ES was significantly worse than that of patients without ES. Bepridil was effective in preventing VF in 6 patients. Conclusions: A high prevalence of ER was found in a subgroup of patients with BrS associated with ES. ES appeared to be suppressed by isoproterenol or quinidine, whereas bepridil and quinidine were effective in the long-term prevention of VF in the highest-risk patients.

Original languageEnglish
Pages (from-to)1122-1128
Number of pages7
JournalCirculation: Arrhythmia and Electrophysiology
Volume7
Issue number6
DOIs
Publication statusPublished - 2014 Dec 1

Fingerprint

Brugada Syndrome
Ventricular Fibrillation
Bepridil
Quinidine
Isoproterenol
Electrocardiography
Implantable Defibrillators
Heart Diseases

Keywords

  • Bepridil
  • Brugada syndrome
  • Electrocardiography
  • Isoproterenol
  • Ventricular fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Medicine(all)

Cite this

Electrical storm in patients with Brugada syndrome is associated with early repolarization. / Kaneko, Yoshiaki; Horie, Minoru; Niwano, Shinichi; Kusano, Kengo F.; Takatsuki, Seiji; Kurita, Takashi; Mitsuhashi, Takeshi; Nakajima, Tadashi; Irie, Tadanobu; Hasegawa, Kanae; Noda, Takashi; Kamakura, Shiro; Aizawa, Yoshiyasu; Yasuoka, Ryobun; Torigoe, Katsumi; Suzuki, Hiroshi; Ohe, Toru; Shimizu, Akihiko; Fukuda, Keiichi; Kurabayashi, Masahiko; Aizawa, Yoshifusa.

In: Circulation: Arrhythmia and Electrophysiology, Vol. 7, No. 6, 01.12.2014, p. 1122-1128.

Research output: Contribution to journalArticle

Kaneko, Y, Horie, M, Niwano, S, Kusano, KF, Takatsuki, S, Kurita, T, Mitsuhashi, T, Nakajima, T, Irie, T, Hasegawa, K, Noda, T, Kamakura, S, Aizawa, Y, Yasuoka, R, Torigoe, K, Suzuki, H, Ohe, T, Shimizu, A, Fukuda, K, Kurabayashi, M & Aizawa, Y 2014, 'Electrical storm in patients with Brugada syndrome is associated with early repolarization', Circulation: Arrhythmia and Electrophysiology, vol. 7, no. 6, pp. 1122-1128. https://doi.org/10.1161/CIRCEP.114.001806
Kaneko, Yoshiaki ; Horie, Minoru ; Niwano, Shinichi ; Kusano, Kengo F. ; Takatsuki, Seiji ; Kurita, Takashi ; Mitsuhashi, Takeshi ; Nakajima, Tadashi ; Irie, Tadanobu ; Hasegawa, Kanae ; Noda, Takashi ; Kamakura, Shiro ; Aizawa, Yoshiyasu ; Yasuoka, Ryobun ; Torigoe, Katsumi ; Suzuki, Hiroshi ; Ohe, Toru ; Shimizu, Akihiko ; Fukuda, Keiichi ; Kurabayashi, Masahiko ; Aizawa, Yoshifusa. / Electrical storm in patients with Brugada syndrome is associated with early repolarization. In: Circulation: Arrhythmia and Electrophysiology. 2014 ; Vol. 7, No. 6. pp. 1122-1128.
@article{56e4bd576a9b46e999b147b7802211e1,
title = "Electrical storm in patients with Brugada syndrome is associated with early repolarization",
abstract = "Background: Electrical storms (ESs) in patients with Brugada syndrome (BrS) are rare though potentially lethal. Methods and Results: We studied 22 men with BrS and ES, defined as ≥3 episodes/d of ventricular fibrillation (VF) and compared their characteristics with those of 110 age-matched, control men with BrS without ES. BrS was diagnosed by a spontaneous or drug-induced type 1 pattern on the ECG in the absence of structural heart disease. Early repolarization (ER) was diagnosed by J waves, ie, >0.1 mV notches or slurs of the terminal portion of the QRS complex. The BrS ECG pattern was provoked with pilsicainide. A spontaneous type I ECG pattern, J waves, and horizontal/descending ST elevation were found, respectively, in 77{\%}, 36{\%}, and 88{\%} of patients with ES, versus 28{\%} (P<0.0001), 9{\%} (P=0.003), and 60{\%} (P=0.06) of controls. The J-wave amplitude was significantly higher in patients with than without ES (P=0.03). VF occurred during undisturbed sinus rhythm in 14 of 19 patients (74{\%}), and ES were controlled by isoproterenol administration. All patients with ES received an implantable cardioverter defibrillator and over a 6.0±5.4 years followup, the prognosis of patients with ES was significantly worse than that of patients without ES. Bepridil was effective in preventing VF in 6 patients. Conclusions: A high prevalence of ER was found in a subgroup of patients with BrS associated with ES. ES appeared to be suppressed by isoproterenol or quinidine, whereas bepridil and quinidine were effective in the long-term prevention of VF in the highest-risk patients.",
keywords = "Bepridil, Brugada syndrome, Electrocardiography, Isoproterenol, Ventricular fibrillation",
author = "Yoshiaki Kaneko and Minoru Horie and Shinichi Niwano and Kusano, {Kengo F.} and Seiji Takatsuki and Takashi Kurita and Takeshi Mitsuhashi and Tadashi Nakajima and Tadanobu Irie and Kanae Hasegawa and Takashi Noda and Shiro Kamakura and Yoshiyasu Aizawa and Ryobun Yasuoka and Katsumi Torigoe and Hiroshi Suzuki and Toru Ohe and Akihiko Shimizu and Keiichi Fukuda and Masahiko Kurabayashi and Yoshifusa Aizawa",
year = "2014",
month = "12",
day = "1",
doi = "10.1161/CIRCEP.114.001806",
language = "English",
volume = "7",
pages = "1122--1128",
journal = "Circulation: Arrhythmia and Electrophysiology",
issn = "1941-3149",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Electrical storm in patients with Brugada syndrome is associated with early repolarization

AU - Kaneko, Yoshiaki

AU - Horie, Minoru

AU - Niwano, Shinichi

AU - Kusano, Kengo F.

AU - Takatsuki, Seiji

AU - Kurita, Takashi

AU - Mitsuhashi, Takeshi

AU - Nakajima, Tadashi

AU - Irie, Tadanobu

AU - Hasegawa, Kanae

AU - Noda, Takashi

AU - Kamakura, Shiro

AU - Aizawa, Yoshiyasu

AU - Yasuoka, Ryobun

AU - Torigoe, Katsumi

AU - Suzuki, Hiroshi

AU - Ohe, Toru

AU - Shimizu, Akihiko

AU - Fukuda, Keiichi

AU - Kurabayashi, Masahiko

AU - Aizawa, Yoshifusa

PY - 2014/12/1

Y1 - 2014/12/1

N2 - Background: Electrical storms (ESs) in patients with Brugada syndrome (BrS) are rare though potentially lethal. Methods and Results: We studied 22 men with BrS and ES, defined as ≥3 episodes/d of ventricular fibrillation (VF) and compared their characteristics with those of 110 age-matched, control men with BrS without ES. BrS was diagnosed by a spontaneous or drug-induced type 1 pattern on the ECG in the absence of structural heart disease. Early repolarization (ER) was diagnosed by J waves, ie, >0.1 mV notches or slurs of the terminal portion of the QRS complex. The BrS ECG pattern was provoked with pilsicainide. A spontaneous type I ECG pattern, J waves, and horizontal/descending ST elevation were found, respectively, in 77%, 36%, and 88% of patients with ES, versus 28% (P<0.0001), 9% (P=0.003), and 60% (P=0.06) of controls. The J-wave amplitude was significantly higher in patients with than without ES (P=0.03). VF occurred during undisturbed sinus rhythm in 14 of 19 patients (74%), and ES were controlled by isoproterenol administration. All patients with ES received an implantable cardioverter defibrillator and over a 6.0±5.4 years followup, the prognosis of patients with ES was significantly worse than that of patients without ES. Bepridil was effective in preventing VF in 6 patients. Conclusions: A high prevalence of ER was found in a subgroup of patients with BrS associated with ES. ES appeared to be suppressed by isoproterenol or quinidine, whereas bepridil and quinidine were effective in the long-term prevention of VF in the highest-risk patients.

AB - Background: Electrical storms (ESs) in patients with Brugada syndrome (BrS) are rare though potentially lethal. Methods and Results: We studied 22 men with BrS and ES, defined as ≥3 episodes/d of ventricular fibrillation (VF) and compared their characteristics with those of 110 age-matched, control men with BrS without ES. BrS was diagnosed by a spontaneous or drug-induced type 1 pattern on the ECG in the absence of structural heart disease. Early repolarization (ER) was diagnosed by J waves, ie, >0.1 mV notches or slurs of the terminal portion of the QRS complex. The BrS ECG pattern was provoked with pilsicainide. A spontaneous type I ECG pattern, J waves, and horizontal/descending ST elevation were found, respectively, in 77%, 36%, and 88% of patients with ES, versus 28% (P<0.0001), 9% (P=0.003), and 60% (P=0.06) of controls. The J-wave amplitude was significantly higher in patients with than without ES (P=0.03). VF occurred during undisturbed sinus rhythm in 14 of 19 patients (74%), and ES were controlled by isoproterenol administration. All patients with ES received an implantable cardioverter defibrillator and over a 6.0±5.4 years followup, the prognosis of patients with ES was significantly worse than that of patients without ES. Bepridil was effective in preventing VF in 6 patients. Conclusions: A high prevalence of ER was found in a subgroup of patients with BrS associated with ES. ES appeared to be suppressed by isoproterenol or quinidine, whereas bepridil and quinidine were effective in the long-term prevention of VF in the highest-risk patients.

KW - Bepridil

KW - Brugada syndrome

KW - Electrocardiography

KW - Isoproterenol

KW - Ventricular fibrillation

UR - http://www.scopus.com/inward/record.url?scp=84925547749&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84925547749&partnerID=8YFLogxK

U2 - 10.1161/CIRCEP.114.001806

DO - 10.1161/CIRCEP.114.001806

M3 - Article

VL - 7

SP - 1122

EP - 1128

JO - Circulation: Arrhythmia and Electrophysiology

JF - Circulation: Arrhythmia and Electrophysiology

SN - 1941-3149

IS - 6

ER -