@article{1fb4db59c3e24c8f8c72711fee399fad,
title = "Spatiotemporal differences in precordial electrocardiographic amplitude before and after flecainide provocation are associated with a history of unstable ventricular arrhythmia in Brugada syndrome",
abstract = "Introduction: A drug provocation test (DPT) is important for the diagnosis of Brugada syndrome (BrS). The link, however, between dynamic changes of electrocardiography (ECG) features after DPT and unstable ventricular arrhythmia (VA) in BrS remains unknown. Methods: Between 2014 and 2019, we assessed 27 patients with BrS (median age: 37.0 [interquartile range, IQR: 22.0–51.0] years; 25 men), including 9 (33.3%) with a history of unstable VA and 18 (66.7%) without. All patients in the study presented with Brugada-like ECG features before DPT. The ECG parameters and dynamic changes (∆) in 12-lead ECGs recorded from the second, third, and fourth intercostal spaces (ICS) before and at 1, 6, 12, 18, and 24 h after DPT (oral flecainide 400 mg) were analyzed. Results: The total amplitude of V1 at the third ICS 18 and 24 h after DPT was significantly lower in patients with a history of unstable VA than in those without. Patients with BrS and unstable VAs had a significantly larger ∆ amplitude of V1 at the second ICS 12 h after DPT than in those without unstable VAs (0.28 [0.18–0.41] mV vs. 0.08 [0.01–0.15] mV, p =.01). A multivariate analysis revealed that the amplitude of V1 at the third ICS 18 and 24 h after DPT and the ∆ amplitude of V1 at the second ICS 12 h after DPT were associated with a history of unstable VA. Conclusion: Nonuniform changes and spatiotemporal differences in precordial ECG features after DPT were observed in patients with BrS and these may be surrogate markers for risk stratification.",
keywords = "Brugada syndrome, drug provocation test, risk stratification, unstable ventricular arrhythmia",
author = "Chen, {Chun Chao} and Chung, {Fa Po} and Lin, {Yenn Jiang} and Chang, {Shih Lin} and Lo, {Li Wei} and Hu, {Yu Feng} and Tuan, {Ta Chuan} and Chao, {Tze Fan} and Liao, {Jo Nan} and Lin, {Chin Yu} and Chang, {Ting Yung} and Wu, {Cheng I.} and Liu, {Chih Min} and Chin, {Chye Gen} and Liu, {Shin Huei} and Cheng, {Wen Han} and Chou, {Ching Yao} and Lugtu, {Isaiah C.} and Chen, {Shih Ann}",
note = "Funding Information: This work was supported by the Ministry of Science and Technology (MOST 109‐2314‐B‐075‐075‐MY3, MOST 109‐2314‐B‐010‐058‐MY2, MOST 109‐2314‐B‐075‐074‐MY3, MOST 109‐2314‐B‐075 ‐076 ‐MY3, grant nos. 107‐2314‐B‐010‐061‐MY2, MOST 106‐2314‐B‐075‐006‐MY3, MOST 106‐2314‐B‐010‐046‐MY3, and MOST 106‐2314‐B‐075‐073‐MY3), Research Foundation of Cardiovascular Medicine, Szu‐Yuan Research Foundation of Internal Medicine, and Taipei Veterans General Hospital (grant nos. V106C‐158, V106C‐104, V107B‐014, V107C‐060, V107C‐054, V108C‐107, and V109C‐113). Funding Information: This work was supported by the Ministry of Science and Technology (MOST 109-2314-B-075-075-MY3, MOST 109-2314-B-010-058-MY2, MOST 109-2314-B-075-074-MY3, MOST 109-2314-B-075 -076 -MY3, grant nos. 107-2314-B-010-061-MY2, MOST 106-2314-B-075-006-MY3, MOST 106-2314-B-010-046-MY3, and MOST 106-2314-B-075-073-MY3), Research Foundation of Cardiovascular Medicine, Szu-Yuan Research Foundation of Internal Medicine, and Taipei Veterans General Hospital (grant nos. V106C-158, V106C-104, V107B-014, V107C-060, V107C-054, V108C-107, and V109C-113). Publisher Copyright: {\textcopyright} 2021 Wiley Periodicals LLC",
year = "2021",
month = mar,
doi = "10.1111/jce.14888",
language = "English",
volume = "32",
pages = "758--765",
journal = "Journal of Cardiovascular Electrophysiology",
issn = "1045-3873",
publisher = "John Wiley and Sons Inc.",
number = "3",
}