Allied Professionals (Non-physician submissions only) -> Clinical Research D-PO03 - Poster Session III (ID 48) Poster

D-PO03-039 - Assessment Of Electrocardiographic Changes Diagnostic Of Brugada Syndrome On Serial Outpatient Ecgs (ID 285)

Abstract

Background: ECG features diagnostic of the Brugada Syndrome (BrS) can be dynamic. Limited studies have rigorously evaluated the temporal stability of Brugada ECG pattern.
Objective: To evaluate spontaneous fluctuations of the Brugada Pattern (BrP) in serial, outpatient ECGs from BrS patients managed within a large healthcare system, and to evaluate the association of these ECG patterns with clinical features.
Methods: In our cohort of BrS patients with at least 2 outpatient ECGs recorded in a non-febrile state, we evaluated serial changes in the BrP (Figure 1). A dynamic pattern was defined as a type I pattern on at least one outpatient ECG. A static pattern was defined as either persistent type I or non-type I pattern on serial ECGs. We evaluated the association between these ECG patterns and clinical characteristics.
Results: In 62 patients with BrS (mean age 45.5 ± 15.3 years, 69.4% male), 440 outpatient ECGs were recorded over a median duration of 41.8 (IQR=7.8-89.7) months. Dynamic BrP was observed in 41/62 (66.1%) patients versus static BrP in 21/62 (33.9%) patients. Of the 21 patients with static BrP, only 3 patients had a persistent type I pattern; all others required a provocative maneuver to diagnose BrS. No significant differences were detected in age, sex, history of cardiac arrest, syncope, atrial fibrillation, family history of SCD or BrS, or inducibility of VF during programmed stimulation.
Conclusion: The majority of BrS patients have a dynamic BrP. Clinical markers of arrhythmic risk were not associated with either a dynamic or static BrP. As such, longitudinal ECG screening and provocative maneuvers remain important tools for diagnosing individuals who are suspected of having BrS.
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