New electrocardiographic criteria to differentiate Type 2 Brugada pattern from incomplete right Bundle branch block in healthy athletes
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hdl:2099.1/17613
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Data2012-10
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Abstract
Diagnosis of type 2 Brugada pattern (BP) (saddle-back morphology) remains challenging because it could be confused with other ECG patterns with a similar morphology of R' in leads V1-V2. This is particular important in healthy athletes where a wrong diagnosis may imply unnecessary discontinuation of physical activity at a competitive level. Aim: To evaluate new and recently published ECG criteria to differentiate type-2 Brugada pattern from incomplete right bundle branch block in athletes. Methods: Surface ECGs from 50 patients with confirmed type-2 Brugada pattern and 58 healthy athletes with R' in leads V1-V2 were compared by two independent observers. The characteristics of the triangle formed by the ascendant and descendant arms of the R' in leads V1-V2 were compared. We analyzed the β angle, the duration of the base of triangle at 5 mm from the high take-off and the duration of the base of the triangle at baseline. ROC-curves were constructed. A p-value <.05 was considered significant. Results: The sensitivity of the β angle > 37º in leads V1-V2 was 85.6% and the specificity was 84.5% (p < 0.002). The sensitivity of the duration of the base of the triangle at 5 mm from high take-off > 4 mm in V1-V2 was 80.2% and the specificity was 86.4% (p < 0.002). The sensitivity of the duration of the base of the triangle at baseline > 1.4 mm in V1-V2 was 89.7% and the specificity was 79.3% (p < 0.04). Conclusions: The three ECG criteria demonstrated high accuracy to distinguish both groups. However, the duration of the base of the triangle at 5 mm of take-off is the easiest method and could be used in clinical practice.. Diagnosis of type 2-3 Brugada pattern (BP) (saddle-back morphology) often presents some difficulties because may be confused with other patterns with R' in V1-V2.The aim of the study is to evaluate new ECG criteria taken from the study of the characteristics of R' in BP and athletes with the aim to recognize the best parameters to differentiate both groups
TitulacióMÀSTER UNIVERSITARI EN ENGINYERIA MATEMÀTICA (Pla 2009)
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