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

Research output: Contribution to journalArticle

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

ASJC Scopus subject areas

  • Nursing(all)

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    Pitzalis, M. V., 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, 42(9), 1632-1637. https://doi.org/10.1016/j.jacc.2003.07.005