QT-Interval Prolongation in Right Precordial Leads: An Additional Electrocardiographic Hallmark of Brugada Syndrome

Maria Vittoria Pitzalis, Matteo Anaclerio, Massimo Iacoviello, Cinzia Forleo, Pietro Guida, Rossella Troccoli, Francesco Massari, Filippo Mastropasqua, Sandro Sorrentino, Andrea Manghisi, Paolo Rizzon

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Abstract

OBJECTIVES: The aim of this study was to evaluate whether the occurrence of the Brugada Syndrome typical electrocardiogram (ECG) pattern (i.e., right bundle branch block, coved-type ST-segment elevation, and T-wave inversion in the right precordial leads) is characterized by a concomitant lengthening of QT intervals in the right precordial leads. BACKGROUND: It has been suggested that the typical ECG pattern of Brugada syndrome is due to a decreased net inward current during phase 1 of the action potential, which also leads to its prolongation in the right epicardium. METHODS: Thirty-two subjects (19 males) age 37 ± 15 years with a suspicious baseline ECG, or who were relatives of Brugada syndrome patients, underwent 12-lead ECG before and after the administration of flecainide. RESULTS: The flecainide test was negative in 14 and positive in 18 subjects. After flecainide administration, the positive ECGs were characterized by a greater QT interval corrected for heart rate (QTc) prolongation in the right precordial leads than that in the negative ECGs (78.2 ± 35.5 ms vs. 22.0 ± 28.4 ms in V1 and 107.1 ± 43.8 ms vs. 26.7 ± 30.1 ms in V2; p <0.01), whereas there was no difference in the QTc prolongation in the left precordial leads (55.2 ± 25.3 ms vs. 35.1 ± 28.1 ms in V5 and 53.1 ± 32.8 ms vs. 27.3 ± 22.4 ms in V6; p = NS). CONCLUSIONS: In accordance with the electrophysiological background, the typical ECG pattern of Brugada syndrome is also characterized by a considerable prolongation of the QT interval in right precordial leads. (J Am Coll Cardiol 2003;42:1632-7)

Original languageEnglish
Pages (from-to)1632-1637
Number of pages6
JournalJournal of the American College of Cardiology
Volume42
Issue number9
DOIs
Publication statusPublished - Nov 5 2003

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Brugada Syndrome
Electrocardiography
Flecainide
Bundle-Branch Block
Pericardium
Action Potentials
Heart Rate

ASJC Scopus subject areas

  • Nursing(all)

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QT-Interval Prolongation in Right Precordial Leads : An Additional Electrocardiographic Hallmark of Brugada Syndrome. / Pitzalis, Maria Vittoria; Anaclerio, Matteo; Iacoviello, Massimo; Forleo, Cinzia; Guida, Pietro; Troccoli, Rossella; Massari, Francesco; Mastropasqua, Filippo; Sorrentino, Sandro; Manghisi, Andrea; Rizzon, Paolo.

In: Journal of the American College of Cardiology, Vol. 42, No. 9, 05.11.2003, p. 1632-1637.

Research output: Contribution to journalArticle

Pitzalis, MV, Anaclerio, M, Iacoviello, M, Forleo, C, Guida, P, Troccoli, R, Massari, F, Mastropasqua, F, Sorrentino, S, Manghisi, A & Rizzon, P 2003, 'QT-Interval Prolongation in Right Precordial Leads: An Additional Electrocardiographic Hallmark of Brugada Syndrome', Journal of the American College of Cardiology, vol. 42, no. 9, pp. 1632-1637. https://doi.org/10.1016/j.jacc.2003.07.005
Pitzalis, Maria Vittoria ; Anaclerio, Matteo ; Iacoviello, Massimo ; Forleo, Cinzia ; Guida, Pietro ; Troccoli, Rossella ; Massari, Francesco ; Mastropasqua, Filippo ; Sorrentino, Sandro ; Manghisi, Andrea ; Rizzon, Paolo. / QT-Interval Prolongation in Right Precordial Leads : An Additional Electrocardiographic Hallmark of Brugada Syndrome. In: Journal of the American College of Cardiology. 2003 ; Vol. 42, No. 9. pp. 1632-1637.
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T1 - QT-Interval Prolongation in Right Precordial Leads

T2 - An Additional Electrocardiographic Hallmark of Brugada Syndrome

AU - Pitzalis, Maria Vittoria

AU - Anaclerio, Matteo

AU - Iacoviello, Massimo

AU - Forleo, Cinzia

AU - Guida, Pietro

AU - Troccoli, Rossella

AU - Massari, Francesco

AU - Mastropasqua, Filippo

AU - Sorrentino, Sandro

AU - Manghisi, Andrea

AU - Rizzon, Paolo

PY - 2003/11/5

Y1 - 2003/11/5

N2 - OBJECTIVES: The aim of this study was to evaluate whether the occurrence of the Brugada Syndrome typical electrocardiogram (ECG) pattern (i.e., right bundle branch block, coved-type ST-segment elevation, and T-wave inversion in the right precordial leads) is characterized by a concomitant lengthening of QT intervals in the right precordial leads. BACKGROUND: It has been suggested that the typical ECG pattern of Brugada syndrome is due to a decreased net inward current during phase 1 of the action potential, which also leads to its prolongation in the right epicardium. METHODS: Thirty-two subjects (19 males) age 37 ± 15 years with a suspicious baseline ECG, or who were relatives of Brugada syndrome patients, underwent 12-lead ECG before and after the administration of flecainide. RESULTS: The flecainide test was negative in 14 and positive in 18 subjects. After flecainide administration, the positive ECGs were characterized by a greater QT interval corrected for heart rate (QTc) prolongation in the right precordial leads than that in the negative ECGs (78.2 ± 35.5 ms vs. 22.0 ± 28.4 ms in V1 and 107.1 ± 43.8 ms vs. 26.7 ± 30.1 ms in V2; p <0.01), whereas there was no difference in the QTc prolongation in the left precordial leads (55.2 ± 25.3 ms vs. 35.1 ± 28.1 ms in V5 and 53.1 ± 32.8 ms vs. 27.3 ± 22.4 ms in V6; p = NS). CONCLUSIONS: In accordance with the electrophysiological background, the typical ECG pattern of Brugada syndrome is also characterized by a considerable prolongation of the QT interval in right precordial leads. (J Am Coll Cardiol 2003;42:1632-7)

AB - OBJECTIVES: The aim of this study was to evaluate whether the occurrence of the Brugada Syndrome typical electrocardiogram (ECG) pattern (i.e., right bundle branch block, coved-type ST-segment elevation, and T-wave inversion in the right precordial leads) is characterized by a concomitant lengthening of QT intervals in the right precordial leads. BACKGROUND: It has been suggested that the typical ECG pattern of Brugada syndrome is due to a decreased net inward current during phase 1 of the action potential, which also leads to its prolongation in the right epicardium. METHODS: Thirty-two subjects (19 males) age 37 ± 15 years with a suspicious baseline ECG, or who were relatives of Brugada syndrome patients, underwent 12-lead ECG before and after the administration of flecainide. RESULTS: The flecainide test was negative in 14 and positive in 18 subjects. After flecainide administration, the positive ECGs were characterized by a greater QT interval corrected for heart rate (QTc) prolongation in the right precordial leads than that in the negative ECGs (78.2 ± 35.5 ms vs. 22.0 ± 28.4 ms in V1 and 107.1 ± 43.8 ms vs. 26.7 ± 30.1 ms in V2; p <0.01), whereas there was no difference in the QTc prolongation in the left precordial leads (55.2 ± 25.3 ms vs. 35.1 ± 28.1 ms in V5 and 53.1 ± 32.8 ms vs. 27.3 ± 22.4 ms in V6; p = NS). CONCLUSIONS: In accordance with the electrophysiological background, the typical ECG pattern of Brugada syndrome is also characterized by a considerable prolongation of the QT interval in right precordial leads. (J Am Coll Cardiol 2003;42:1632-7)

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