This article is more than 5 years old. Information may no longer be current.

Exercise-induced ST segment elevation augmentation predictive of cardiac events in setting of Brugada syndrome

Makimoto H. J Am Coll Cardiol. 2010;56:1576-1584.
Viskin S. J Am Coll Cardiol. 2010;56:1585-1588.

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

More than one-third of patients with Brugada syndrome during recovery from exercise testing were reported to have ST segment elevation augmentation, which according to study data published in the Journal of the American College of Cardiology proved to be an independent predictor of cardiac events.

Researchers enrolled 93 patients (91 men; mean age, 46 ± 14 years) with Brugada syndrome and 102 healthy controls (97 men; mean age, 46 ± 17 years). All patients underwent treadmill testing, and the clinical endpoint was defined as occurrence of ventricular fibrillation, sustained ventricular tachyarrhythmia or sudden cardiac death.

Thirty-four (37%) patients with Brugada syndrome were found to have augmentation of ST segment elevation >0.05 mV in V₁ or V₃ leads compared with baseline at early recovery (1-4 minutes), which was not observed in any of the control patients. During the 76 ± 38 months of follow-up, the group of patients with Brugada syndrome who had augmented ST segment elevation had a significantly higher incidence of atrial fibrillation (44%) vs. those with Brugada syndrome and no augmentation (17%; P=.004).

Researchers also found that ST segment elevation augmentation at early recovery was an independent predictor for cardiac events (P=.007), which was most prominent in patients with syncope alone, as well as asymptomatic patients.

“This is the first systematic report on the relationship between ST segment augmentation during recovery from exercise and prognosis for [patients with] Brugada syndrome,” the researchers commented in their study. “Augmentation of ST segment elevation during recovery from exercise testing was specific in patients with Brugada syndrome and can be a predictor of poor prognosis, especially for patients with syncope alone and for asymptomatic patients.”

However, Sami Viskin, MD, and Raphael Rosso, MD, with the Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Israel, said in an accompanying editorial there are three points that argue against embracing the exercise test as the main tool for defining the need for therapy among asymptomatic patients.

First, they wrote, the test failed to identify 68% of patients with a history of cardiac arrest; second, the reproducibility of the test was not tested; and third, the study included only 36 patients with asymptomatic Brugada syndrome, and that 8% of them had arrhythmic events during follow-up, which suggested to them that this was an a priori high-risk population.

Follow CardiologyToday.com on Twitter.