Electrical Space-Time Abnormalities of Ventricular Depolarization in Patients with Brugada Syndrome and Patients with Complete Right-Bundle Branch Blocks Studied by Magnetocardiography

• Published in: Pacing and clinical electrophysiology Vol. 29; no. 1; pp. 15 - 20
• Main Authors: KANDORI, AKIHIKO, MIYASHITA, TSUYOSHI, OGATA, KUNIOMI, SHIMIZU, WATARU, YOKOKAWA, MIKI, KAMAKURA, SHIRO, MIYATAKE, KUNIO, TSUKADA, KEIJI, YAMADA, SATSUKI, WATANABE, SHIGEYUKI, YAMAGUCHI, IWAO
• Format: Journal Article
• Language: English
• Published: 350 Main Street , Malden , MA 02148-5018 , USA and 9600 Garsington Road , Oxford OX4 2DQ , UK Blackwell Science Inc 01.01.2006
• Subjects: Adult; arrhythmia; Brugada syndrome; Bundle-Branch Block - diagnosis; Bundle-Branch Block - physiopathology; depolarization; Electrocardiography - methods; Female; Heart Conduction System - physiopathology; Humans; Magnetics; magnetocardiogram; Male; Middle Aged; right-bundle branch block; Syndrome
• ISSN: 0147-8389; 1540-8159
• DOI: 10.1111/j.1540-8159.2006.00296.x

Background: Both ventricular depolarization abnormalities (QRS complex) and repolarization ones (ST/T) are still controversial in literature. The objective of this study was to clarify the space‐time variations that occur in patients carriers of Brugada syndrome using Magnetocardiography and also compare them with cases of complete right‐bundle branch block (CRBBB) and individuals without any dromotropic disorder (control group). Methods and Results: Magnetocardiograms (MCGs) of Brugada syndrome patients (n = 16), CRBBB patients (n = 14), and members of a control group (n = 46) at rest were recorded. The MCGs were used to produce a whole‐heart electrical‐activation diagram (W‐HEAD), which can visualize the spatial time‐variant activation in the whole heart. In the W‐HEAD pattern, three activations were located in the left ventricle, and CRBBB patients had a wide peak with about 65‐ms delay on the right anterior side. While the Brugada syndrome pattern has a posteromedian left‐ventricle excitation, that is half the amplitude that occurs in CRBBB patients, the electrical conduction rate to the posterosuperior septum area was low. Conclusions: The W‐HEAD data made it possible to visualize space‐time depolarization abnormalities. These findings suggest that the electrical conduction rate to the posterosuperior septum area in Brugada syndrome cases is low, and this low activation may be a feature of typical Brugada syndrome.