KMID : 0191120210360110075
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Journal of Korean Medical Science 2021 Volume.36 No. 11 p.75 ~ p.75
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Right Ventricular Longitudinal Conduction Delay in Patients with Brugada Syndrome
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Yoon Nam-Sik
Jeong Hyung-Ki Lee Ki-Hong Park Hyung-Wook Cho Jeong-Gwan
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Abstract
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Background: The mechanism of Brugada syndrome (BrS) is still unclear, with different researchers favoring either the repolarization or depolarization hypothesis. Prolonged longitudinal activation time has been verified in only a small number of human right ventricles (RVs). The purpose of the present study was to demonstrate RV conduction delays in BrS.
Methods: The RV outflow tract (RVOT)-to-RV apex (RVA) and RVA-to-RVOT conduction times were measured by endocardial stimulation and mapping in 7 patients with BrS and 14 controls.
Results: Patients with BrS had a longer PR interval (180 ¡¾ 12.6 vs. 142 ¡¾ 6.7 ms, P = 0.016). The RVA-to-RVOT conduction time was longer in the patients with BrS than in controls (stimulation at 600 ms, 107 ¡¾ 9.9 vs. 73 ¡¾ 3.4 ms, P = 0.001; stimulation at 500 ms, 104 ¡¾ 12.3 vs. 74 ¡¾ 4.2 ms, P = 0.037; stimulation at 400 ms, 107 ¡¾12.2 vs. 73 ¡¾ 5.1 ms, P = 0.014). The RVOT-to-RVA conduction time was longer in the patients with BrS than in controls (stimulation at 500 ms, 95 ¡¾ 10.3 vs. 62 ¡¾ 4.1 ms, P = 0.007; stimulation at 400 ms, 94 ¡¾11.2 vs. 64 ¡¾ 4.6 ms, P = 0.027). The difference in longitudinal conduction time was not significant when isoproterenol was administered.
Conclusion: The patients with BrS showed an RV longitudinal conduction delay obviously. These findings suggest that RV conduction delay might contribute to generate the BrS phenotype.
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KEYWORD
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Brugada Syndrome, Conduction Delay
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