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Variants of Brugada Syndrome and Early Repolarization Syndrome: An Expanded Concept of J-Wave Syndrome

Authors
 SUNG‐HWAN KIM  ;  GI‐BYOUNG NAM  ;  SUNG‐CHEOL YUN  ;  HYUNG OH CHOI  ;  KEE‐JOON CHOI  ;  BOYOUNG JOUNG  ;  HUI‐NAM PAK  ;  MOON‐HYOUNG LEE  ;  SUNG SOON KIM  ;  SEUNG‐JUNG PARK  ;  YOUNG KEUN ON  ;  JUNE SOO KIM  ;  IL‐YOUNG OH  ;  EUE‐KEUN CHOI  ;  SEIL OH  ;  YUN‐SHIK CHOI  ;  JONG IL CHOI  ;  SANG WEON PARK  ;  YOUNG‐HOON KIM  ;  YONG‐SEOG OH  ;  MAN YOUNG LEE  ;  HONG EUY LIM  ;  YOUNG‐SOO LEE  ;  YONGKEUN CHO  ;  JUN KIM  ;  KYOUNG‐SUK RHEE  ;  DONG‐IL LEE  ;  DAE KYOUNG CHO  ;  YOU‐HO KIM 
Citation
 PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, Vol.40(2) : 162-174, 2017 
Journal Title
 PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY 
ISSN
 0147-8389 
Issue Date
2017
MeSH
Brugada Syndrome/classification* ; Brugada Syndrome/diagnosis* ; Diagnosis, Differential ; Electrocardiography/methods* ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; ST Elevation Myocardial Infarction/classification* ; ST Elevation Myocardial Infarction/diagnosis* ; Sensitivity and Specificity
Keywords
J-waves ; early repolarization ; electrocardiography ; sudden cardiac death ; ventricular fibrillation
Abstract
BACKGROUND: The role of J-waves in the pathogenesis of ventricular fibrillation (VF) occurring in structurally normal hearts is important. METHODS: We evaluated 127 patients who received an implantable cardioverter-defibrillator (ICD) for Brugada syndrome (BS, n = 53), early repolarization syndrome (ERS, n = 24), and patients with unknown or deferred diagnosis (n = 50). Electrocardiography (ECG), clinical characteristics, and ICD data were analyzed. RESULTS: J-waves were found in 27/50 patients with VF of unknown/deferred diagnosis. The J-waves were reminiscent of those seen in BS or ERS, and this subgroup of patients was termed variants of ERS and BS (VEB). In 12 VEB patients, the J/ST/T-wave morphology was coved, although amplitudes were <0.2 mV. In 15 patients, noncoved-type J/ST/T-waves were present in the right precordial leads. In the remaining 23 patients, no J-waves were identified. VEB patients exhibited clinical characteristics similar to those of BS and ERS patients. Phenotypic transition and overlap were observed among patients with BS, ERS, and VEB. Twelve patients with BS had background inferolateral ER, while five ERS patients showed prominent right precordial J-waves. Patients with this transient phenotype overlap showed a significantly lower shock-free survival than the rest of the study patients. CONCLUSIONS: VEB patients demonstrate ECG phenotype similar to but distinct from those of BS and ERS. The spectral nature of J-wave morphology/distribution and phenotypic transition/overlap suggest a common pathophysiologic background in patients with VEB, BS, and ERS. Prognostic implication of these ECG variations requires further investigation.
Full Text
https://onlinelibrary.wiley.com/doi/abs/10.1111/pace.13000
DOI
10.1111/pace.13000
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Lee, Moon-Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160817
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