Utility of high and standard right precordial leads during ajmaline testing for the diagnosis of Brugada syndrome

Govindan, Malini; Batchvarov, Velislav N.; Raju, Hariharan; Shanmugam, Nesan; Bizrah, Mukhtar; Bastiaenen, Rachael; Kiotsekoglou, Anatoli; Camm, John; Behr, Elijah R.
December 2010
Heart;Dec2010, Vol. 96 Issue 23, p1904
Academic Journal
Aims The authors sought to assess the value of the high right precordial leads (RPL) to detect the Type I Brugada ECG pattern in patients suspected of carrying Brugada syndrome (BrS). Methods Ajmaline testing using 15-lead ECGs was performed in 183 patients suspected of carrying BrS. Standard 12-lead ECG with V1-V3 recorded from the fourth intercostal space and an additional three leads placed over V1-V3 recorded from the third intercostal space were analysed. ECGs were analysed for a Type I ECG pattern in either the standard or high RPLs. Results Of the 183 tests, 31 (17%) were positive, and 152 were negative. In all positive studies, at least one high RPL became positive. In 13/31 (42%) cases, the Type I ECG pattern could be observed only in the high RPLs. Standard or high V3 were never positive before standard or high V1-V2. In seven patients, a Type I pattern was seen in one standard and one high RPL (vertical relationship). Conclusions The high RPLs are more sensitive than the conventional 12-lead ECG alone and initial observations suggest that they remain specific for BrS, while standard and high lead V3 offer redundant data. A vertical relationship of type 1 patterns may have a similar diagnostic value to that of a horizontal pair.


Related Articles

  • Additional ECG Leads May Not Provide Benefit in Detecting Brugada Syndrome.  // MD Conference Express;Oct2010, p16 

    The article discusses the use of additional electrocardiogram (ECG) leads in the detection of Brugada Syndrome (BrS) presented by Raymond Massay and colleagues during the 25th Annual Caribbean Cardiology Conference. It says that the traditional 12-lead ECG was no more sensitive for Type 1...

  • Electrical aspects of Brugada: hyperkalaemia and intoxication with phenothiazines. Garnier, F.; Mathe, A.; Bruyeres, R. // Heart;Dec2008, Vol. 94 Issue 12, p1578 

    The article reports on a case of Brugada syndrome, being diagnosed by electrocardiography (ECG), in the context of hyperkalaemia, in a 28-year-old male patient receiving treatment with high doses of a psychotropic drug. It notes that Brugada syndrome is characterized by a hereditary anomaly in...

  • The Resting Electrocardiogram as a Screening Test. Sox Jr., Harold C.; Garber, Alan M.; Littenberg, Benjamin // Annals of Internal Medicine;9/15/89, Vol. 111 Issue 6, p489 

    Discusses the evidence that a resting electrocardiogram (ECG) predicts cardiac disease in healthy persons. Role of ECG in screening for coronary artery disease; Reasons that some experts recommend against using resting ECG to screen for coronary heart disease; Definition of screening;...

  • The U wave in the electrocardiogram: A solution for a 100-year-old riddle Ritsema van Eck, Henk J.; Kors, Jan A.; van Herpen, Gerard // Cardiovascular Research;Aug2005, Vol. 67 Issue 2, p256 

    Abstract: Objective: In the electrocardiogram (ECG) the U wave follows the T, which is considered to reflect the repolarization of the cardiac ventricles. Despite the U wave''s well-known clinical relevance, a satisfactory explanation of its origin is still outstanding. We have undertaken to...

  • e·lec·tro·car·di·o ·gram.  // American Heritage Student Science Dictionary;2009, p111 

    A definition of the term "electrocardiogram" is presented. It refers to the recording of the electrical activity of the heart. The electrocardiogram is used by doctors to analyze how well the heart is working and to diagnose abnormal heart rhythms.

  • ECG QUIZ.  // Pulse;6/7/2004, Vol. 64 Issue 23, p52 

    Presents a quiz on the interpretation of electrocardiogram readings on elderly patients.

  • Mobile telemetry for pre-hospital thrombolysis: problems and solutions. Pedley, David K.; Beedie, Stephen; Ferguson, James // Journal of Telemedicine & Telecare;Aug2005 Supplement 1, Vol. 11, p78 

    In the Angus region of Scotland, we have used mobile telemetry to facilitate pre-hospital thrombolysis by paramedic staff. An initial survey demonstrated that connection could be achieved in all but three locations. In the first year of operation, 229 contacts were received. Communication...

  • ON-LINE AND OFF-LINE ECG AND MOTION ACTIVITY MONITORING SYSTEM FOR ATHLETES. Korsakas, Stasys; Vainoras, Alfonsas; Gargasas, Liudas; Miškinis, Vytenis; Ruseckas, Rimtautas; Jurkonis, Vidmantas; Vitartaitė, Algė; Poderys, Jonas // Education. Physical Training. Sport;2007, Vol. 66 Issue 3, p31 

    The aim of this paper is to present a new ECG and motion activity monitoring and on-line analysis system for athletes. The developed system is intended to facilitate the coach in optimizing and individualizing the training of elite athletes. The hardware system consists of the device for...

  • Country cardiograms case 26: Answer. MacLellan, Keith // Canadian Journal of Rural Medicine;Fall2004, Vol. 9 Issue 4, p266 

    Presents an electrocardiography (ECG) interpretation to country cardiograms case 26. Explanation on the ECG features in case 26; Assessment on the results.


Read the Article


Sign out of this library

Other Topics