Background: The response of the ST-segment in the right precordial leads to Na+ channel blockers in patients without structural heart disease and a typical Brugada-type ECG has not been fully elucidated.
Methods And Results: A pilsicainide challenge test was performed in 161 patients and according to recently established ECG criteria and an organized computer algorithm, the ST morphology was classified and the maximum increase in the J wave amplitude (maxDeltaJ) from the standard and high right precordial leads V1-3 was examined. Before the test, subjects exhibiting type 1 ECG in the standard leads were excluded. After administering pilsicainide, type 1 ECGs in the standard leads were observed in 31 cases and a maxDeltaJ of >or=200 microV was observed in 29 cases (23 type 1, 2 type 2/3 and 4 normal ECGs). In the additional higher right precordial leads, type 1 ECGs were observed in 55 cases and a maxDeltaJ of >or=200 microV was observed in 45 cases (42 type 1 and 3 type 2/3 ECGs).
Conclusions: A maxDeltaJ>or=200 microV induced by pilsicainide, including that measured in the high right precordial leads, was associated with a change mainly to a type 1 ECG.
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http://dx.doi.org/10.1253/circj.71.57 | DOI Listing |
Life (Basel)
November 2024
Department of Cardiology, Bagdasar-Arseni Emergency Hospital, Carol Davila University of Medicine and Pharmacy, 022328 Bucharest, Romania.
Background: Cardiac resynchronization therapy (CRT) is an essential treatment for patients with symptomatic heart failure and ventricular conduction abnormalities. Low-ejection-fraction (EF) cardiomyopathy often involves a wide QRS complex displaying a left bundle branch block (LBBB) morphology and markedly delayed activation of the LV lateral wall. Following CRT, patients with heart failure and LBBB have better outcomes and quality-of-life improvements.
View Article and Find Full Text PDFJ Mol Cell Cardiol
January 2025
Department of Biochemistry, University of Cambridge, Tennis Court Road, Cambridge CB2 1QW, UK. Electronic address:
Introduction: Brugada Syndrome (BrS) is an inherited arrhythmia syndrome characterised by ST-segment elevation in the right precordial ECG leads and is associated with an increased risk of sudden cardiac death. We identify and characterise a novel SCN3B variant encoding the regulatory β3-subunit of the cardiac voltage-gated sodium channel, Na1.5.
View Article and Find Full Text PDFJ Electrocardiol
December 2024
Centro de Investigaciones Médicas Florida, Buenos Aires, Argentina. Electronic address:
Front Cardiovasc Med
December 2024
Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
Background: Arrhythmogenic cardiomyopathy (ACM) is an inherited cardiomyopathy characterized by high risks of sustained ventricular tachycardia (sVT) and sudden cardiac death. Identifying patients with high risk of sVT is crucial for the management of ACM.
Methods: A total of 147 ACM patients were retrospectively enrolled in the observational study and divided into training and validation groups.
Med J Armed Forces India
December 2024
Clinical Tutor, Department of Internal Medicine, Armed Forces Medical College, C/o 56 APO, India.
High altitude pulmonary oedema (HAPO) is a common emergency seen at high altitude. It can be associated with electrocardiogram (ECG) changes due to pulmonary arterial hypertension in the form of ST elevation and T wave inversion in the right precordial leads, which mimic acute coronary syndrome. These changes can lead to confusion in diagnosis and management.
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