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dST-Tiso Interval, a Novel Electrocardiographic Marker of Ventricular Arrhythmia Inducibility in Individuals With Ajmaline-Induced Brugada Type I Pattern
- Source :
- The American journal of cardiology. 159
- Publication Year :
- 2021
-
Abstract
- The aim of this study was to investigate the reliability of a novel electrocardiographic (ECG) marker in predicting ventricular arrhythmia (VA) inducibility in individuals with drug-induced Brugada syndrome (BrS) type I pattern. Consecutive patients with drug-induced type I BrS pattern underwent programmed ventricular stimulation (PVS) and, according to their response, were divided into 2 groups. Clinical characteristics and 12-lead ECG intervals before and after ajmaline infusion were compared between the 2 groups. A novel ECG marker named dST-Tiso interval consisting in the interval between the onset of the coved ST-segment elevation and its termination at the isoelectric line was also evaluated. Our cohort included 76 individuals (median age 44 years, 75% male). Twenty-five (32.9%) had VA inducibility requiring defibrillation. As compared with not inducible subjects, those with VA inducibility were more frequently male (92% vs 65%, p = 0.013), had longer PQ interval (basal: 172 vs 152 ms, p = 0.033; after ajmaline: 216 vs 200 ms, p = 0.040), higher J peak (0.6 vs 0.5 mV, p = 0.006) and longer dST-Tiso (360 vs 240 ms, p < 0.001). The dST-Tiso showed a C-statistics of 0.90 (95% confidence interval: 0.82 to 0.99) and an adjusted odds ratio for VA of 1.03 (1.01 to 1.04, p < 0.001). A dST-Tiso interval >300 ms yielded a sensitivity of 92.0%, a specificity of 90.2%, positive and negative predictive values of 82.1% and 95.8%. In conclusion, the dST-Tiso interval is a powerful predictor of VA inducibility in drug-induced BrS type I pattern. External validation is needed, but this marker might be useful in the clinical counseling process of these individuals before invasive PVS.
- Subjects :
- Adult
Male
medicine.medical_specialty
Defibrillation
medicine.medical_treatment
Heart Ventricles
Basal (phylogenetics)
Electrocardiography
Predictive Value of Tests
Internal medicine
Positive predicative value
medicine
Humans
PR interval
Brugada Pattern
Brugada syndrome
Brugada Syndrome
Ajmaline
dST-Tiso Interval
business.industry
External validation
dST-Tiso Interval, Ajmaline , Brugada Pattern, Brugada Syndrome
Reproducibility of Results
Arrhythmias, Cardiac
Middle Aged
medicine.disease
Cohort
Cardiology
Ventricular arrhythmia
Female
business
Cardiology and Cardiovascular Medicine
Anti-Arrhythmia Agents
medicine.drug
Electrocardiographic Markers
Subjects
Details
- ISSN :
- 18791913
- Volume :
- 159
- Database :
- OpenAIRE
- Journal :
- The American journal of cardiology
- Accession number :
- edsair.doi.dedup.....a7fcbaabdcb2332943b8e4cc737eb152