Prognostic significance of a low T/R ratio in Brugada syndrome.

To determine the prognostic value of a low T/R ratio, defined as the amplitude ratio between the T waves and the R waves, in patients (pts) with a spontaneous type-1 Brugada pattern (SBT1). Abnormalities of myocardial repolarization may play a key role in the initiation of ventricular fibrillation (VF) in Brugada syndrome (BrS). Recent studies have shown that the height of the T waves and the T/R ratio are inversely proportional to sudden cardiac arrest (SCA) risk in early repolarization syndrome and hypertrophic cardiomyopathy. In an international retrospective study, we reviewed 115 pts. (105 males, 91.3%). 45 had VF and/or SCA (38.7 ± 11.5 years old, all males), while 70 (49.3 ± 12.0 years, 10 women) remained free of ventricular arrhythmia. 6 ECG markers plus the T/R ratio in leads V5 & II were studied. The T/R ratio among leads II & V5 was significantly lower in the VF/SCA group (0.24 [0.14; 0.38]vs. 0.34 [0.24; 0.45]; p = 0.006). 44.4% of pts. in the VF/SCA group had a lowest T/R ratio among leads II & V5 ≤ 0.17 compared to 11.4% in the non-VF/SCA group (p < 0.001). In multivariate analysis, a lowest T/R ratio among leads II & V5 ≤ 0.17 was independently associated with VF/SCA (OR 6.10, 95% CI 1.92-19.40; p = 0.002). Type 1 Brugada pattern in the peripheral leads (OR 10.78) and early repolarization (OR 3.60) were other independent markers of VF/SCA. A low T/R ratio among leads II & V5 is an independent marker for VF/SCA risk in patients with type-1 Brugada pattern. Copyright © 2020 Elsevier Inc. All rights reserved.

Citation

Antoine Delinière, Adrian Baranchuk, Francis Bessière, Pascal Defaye, Eloi Marijon, Olivier Le Vavasseur, Dan Dobreanu, Alina Scridon, Antoine Da Costa, Etienne Delacrétaz, Claude Kouakam, Romain Eschalier, Fabrice Extramiana, Antoine Leenhardt, Haran Burri, Pierre-François Winum, Jérôme Taieb, Jérôme Bouet, Horia Rosianu, Philippe Chevalier. Prognostic significance of a low T/R ratio in Brugada syndrome. Journal of electrocardiology. 2020 Nov - Dec;63:6-11

Mesh Tags

PMID: 33011474

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