Heart Rhythm
Volume 7, Issue 2 , Pages 218-224 , February 2010

Atrial electrophysiological and structural remodeling in high-risk patients with Brugada syndrome: Assessment with electrophysiology and echocardiography

  • Norihisa Toh, MD

      Affiliations

    • Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
    • Corresponding Author InformationAddress reprint requests and correspondence: Dr. Norihisa Toh, Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Okayama City, Okayama 700-8558, Japan
    • ,
  • Hiroshi Morita, MD

      Affiliations

    • Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
    • ,
  • Satoshi Nagase, MD

      Affiliations

    • Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
    • ,
  • Manabu Taniguchi, MD

      Affiliations

    • Division of Cardiac Care Unit, Okayama University Hospital, Okayama, Japan
    • ,
  • Daiji Miura, PhD

      Affiliations

    • Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
    • ,
  • Nobuhiro Nishii, MD

      Affiliations

    • Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
    • ,
  • Kazufumi Nakamura, MD

      Affiliations

    • Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
    • ,
  • Tohru Ohe, MD, FHRS

      Affiliations

    • Department of Cardiology, Sakakibara Heart Institute of Okayama, Okayama, Japan
    • ,
  • Kengo F. Kusano, MD

      Affiliations

    • Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
    • ,
  • Hiroshi Ito, MD

      Affiliations

    • Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan

Received 26 August 2009 ,Accepted 29 October 2009.

References 

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  2. Brugada J, Brugada R, Brugada P. Right bundle-branch block and ST-segment elevation in leads V1 through V3: a marker for sudden death in patients without demonstrable structural heart disease. Circulation. 1998;97:457–460
  3. Brugada P, Brugada J. Right bundle branch block, persistent ST-segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome (A multicenter report). J Am Coll Cardiol. 1992;20:1391–1396
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  5. Morita H, Kusano-Fukushima K, Nagase S, et al. Atrial fibrillation and atrial vulnerability in patients with Brugada syndrome. J Am Coll Cardiol. 2002;40:1437–1444
  6. Kusano KF, Taniyama M, Nakamura K, et al. Atrial fibrillation in patients with Brugada syndrome relationships of gene mutation, electrophysiology, and clinical backgrounds. J Am Coll Cardiol. 2008;51:1169–1175
  7. Corrado D, Nava A, Buja G, et al. Familial cardiomyopathy underlies syndrome of right bundle branch block, ST segment elevation and sudden death. J Am Coll Cardiol. 1996;27:443–448
  8. Takagi M, Aihara N, Kuribayashi S, et al. Abnormal response to sodium channel blockers in patients with Brugada syndrome: augmented localised wall motion abnormalities in the right ventricular outflow tract region detected by electron beam computed tomography. Heart. 2003;89:169–174
  9. Catalano O, Antonaci S, Moro G, et al. Magnetic resonance investigations in Brugada syndrome reveal unexpectedly high rate of structural abnormalities. Eur Heart J. 2009;30:2241–2248
  10. Frustaci A, Priori SG, Pieroni M, et al. Cardiac histological substrate in patients with clinical phenotype of Brugada syndrome. Circulation. 2005;112:3680–3687
  11. Coronel R, Casini S, Koopmann TT, et al. Right ventricular fibrosis and conduction delay in a patient with clinical signs of Brugada syndrome: a combined electrophysiological, genetic, histopathologic, and computational study. Circulation. 2005;112:2769–2777
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  15. Bigi MA, Aslani A, Shahrzad S. Clinical predictors of atrial fibrillation in Brugada syndrome. Europace. 2007;9:947–950
  16. Abhayaratna WP, Seward JB, Appleton CP, et al. Left atrial size: physiologic determinants and clinical applications. J Am Coll Cardiol. 2006;47:2357–2363
  17. Appleton CP, Galloway JM, Gonzalez MS, Gaballa M, Basnight MA. Estimation of left ventricular filling pressures using two-dimensional and Doppler echocardiography in adult patients with cardiac disease (Additional value of analyzing left atrial size, left atrial ejection fraction and the difference in duration of pulmonary venous and mitral flow velocity at atrial contraction). J Am Coll Cardiol. 1993;22:1972–1982
  18. Chen Q, Kirsch GE, Zhang D, et al. Genetic basis and molecular mechanism for idiopathic ventricular fibrillation. Nature. 1998;392:293–296
  19. Schott JJ, Alshinawi C, Kyndt F, et al. Cardiac conduction defects associate with mutations in SCN5A. Nat Genet. 1999;23:20–21
  20. Makiyama T, Akao M, Shizuta S, et al. A novel SCN5A gain-of-function mutation M1875T associated with familial atrial fibrillation. J Am Coll Cardiol. 2008;52:1326–1334
  21. McNair WP, Ku L, Taylor MR, et al. SCN5A mutation associated with dilated cardiomyopathy, conduction disorder, and arrhythmia. Circulation. 2004;110:2163–2167

 The authors thank Yasuharu Tanabe, RDCS, and Nobuhisa Watanabe, RDCS, for obtaining the excellent echocardiographic data.

PII: S1547-5271(09)01221-1

doi: 10.1016/j.hrthm.2009.10.035

Heart Rhythm
Volume 7, Issue 2 , Pages 218-224 , February 2010

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