QT-interval prolongation inright precordial leads

• DOI: 10.1016/j.jacc.2003.07.005
• Publication Date: 2003-11-06T09:24:37Z
• Authors: Maria Vittoria Pi...; Matteo Anaclerio; Massimo Iacoviello; Cinzia Forleo; Pietro Guida; Rossella Troccoli; Francesco Massari; Filippo Mastropasqua; Sandro Sorrentino; Andrea Manghisi; Paolo Rizzon
• Keywords: Adult; Male; Flecainide; Bundle-Branch Block; Middle Aged; Sensitivity and Specificity; Electrocardiography; 03 medical and health sciences; 0302 clinical medicine; ROC Curve; Heart Conduction System; Humans; Female; Cardiology and Cardiovascular Medicine; Anti-Arrhythmia Agents; Polymorphism, Single-Stranded Conformational

The aim of this study was to evaluate whether the occurrence of the Brugada Syndrome typical electrocardiogram (ECG) pattern (i.e., right bundle branch block, coved-type ST-segment elevation, and T-wave inversion in the right precordial leads) is characterized by a concomitant lengthening of QT intervals in the right precordial leads.It has been suggested that the typical ECG pattern of Brugada syndrome is due to a decreased net inward current during phase 1 of the action potential, which also leads to its prolongation in the right epicardium.Thirty-two subjects (19 males) age 37 +/- 15 years with a suspicious baseline ECG, or who were relatives of Brugada syndrome patients, underwent 12-lead ECG before and after the administration of flecainide.The flecainide test was negative in 14 and positive in 18 subjects. After flecainide administration, the positive ECGs were characterized by a greater QT interval corrected for heart rate (QTc) prolongation in the right precordial leads than that in the negative ECGs (78.2 +/- 35.5 ms vs. 22.0 +/- 28.4 ms in V(1) and 107.1 +/- 43.8 ms vs. 26.7 +/- 30.1 ms in V(2); p < 0.01), whereas there was no difference in the QTc prolongation in the left precordial leads (55.2 +/- 25.3 ms vs. 35.1 +/- 28.1 ms in V(5) and 53.1 +/- 32.8 ms vs. 27.3 +/- 22.4 ms in V(6); p = NS).In accordance with the electrophysiological background, the typical ECG pattern of Brugada syndrome is also characterized by a considerable prolongation of the QT interval in right precordial leads.