ISSN: 1223-1533

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THE VARIATION OF VENTRICULAR LATE POTENTIALS BY THE POSTURAL CHANGE IN PATIENTS WITH BRUGADA SYNDROME


Authors: Amino Mari, Yoshioka Koichiro, Nakamura Mari, Kanda Shigetaka, Deguchi Yoshiaki, Kobayashi Yoshinori, Tanabe Teruhisa, Ikari Yuji




 

Introduction: Recently we reported the unique circadian rhythm on late potentials (LP) in high risk Brugada patients (Circ J 2013,75,610-8). However the LP changes affected by a body position remain unclear. The purpose of this study was to investigate the variance of LP in postural change.

 

Methods: Twenty-five Brugada patients were enrolled (24 men, mean age 47.3 y/o). LPs were studied in a standard manner using Holter ECG (SCM-8000 system, Fukuda Denshi, Tokyo, Japan), and recorded in the supine, left lateral, right lateral, prone and sit positions. It was considered as positive for LPs when 2 criteria of 3 parameters were filled (fQRSd>105ms, LAS40 >39 ms, or RMS40 <15JV defined as Fukuda Denshi). Recordings were accepted when electrical noise was <0.8JV.

 

Results: Averaged fQRS were 132.2±15.1msec in the supine position. It has no significance with the value in the left lateral or right lateral positions. However it was significantly decreased in the prone/sit positions (128.2±13.1/123.0±14.5msec) . Averaged LAS40 were 47.0±11.5msec in the supine position. It has no significance with the value in the left lateral or right lateral positions. However it was significantly decreased in the prone/sit positions (44.5±10.1/43.9±7.7msec). Averaged RMS40 were 11.2±7.8msec in the supine position. It has no significance with the value in the left lateral or right lateral positions.  However  it  was  increased  in  the  prone  /sit positions (14.3±7.0/14.0±8.1JV). As a result, the positive percentage of LPs was high in order of supine = left lateral = right lateral > prone > sit positions.

 

Conclusion: The positive ratio of LP did not affected by the left lateral or right lateral positions in Brugada patients. On the other hand the prone and sit positions significantly improved LPs.