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Usefulness of ST elevation score by using vector-projected virtual 187-channel ECG for risk stratification in patients with Brugada-type ECG pattern

Journal of Arrhythmia. 2012;28(4):207-213 DOI 10.1016/j.joa.2011.11.001


Journal Homepage

Journal Title: Journal of Arrhythmia

ISSN: 1880-4276 (Print); 1883-2148 (Online)

Publisher: Wiley

Society/Institution: Japanese Heart Rhythm Society

LCC Subject Category: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system

Country of publisher: Australia

Language of fulltext: English

Full-text formats available: PDF, HTML



Shoko Ishikawa

Shinichi Niwano

Jun Kishihara

Ryuta Imaki

Masami Murakami

Yuya Aoyama

Akira Satoh

Hiroe Niwano

Tohru Izumi


Blind peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 45 weeks


Abstract | Full Text

Background: Although powerful defibrillation devices are available in clinical practice, risk stratification is important in asymptomatic Brugada syndrome. In this study, vector-projected 187-channel electrocardiogram (VP-ECG) was used to calculate the ST-elevation score in Brugada-type ECG and test its usefulness in risk stratification. Methods and results: VP-ECG was recorded in 108 patients with Brugada-type ECG having ventricular fibrillation (VF) episodes (±; n=13/95). The ST morphologies were evaluated in 80/187 precordial leads. The coved- and saddleback types (4–6 vs. 1–3 points) of ST-elevation scores in 332 recordings were 58±57 points, which were calculated using virtual ECG leads. Compared with types 1–3 ECG patterns, the scores were significantly different among the groups (107±65, 62±45, and 14±22, respectively; p<0.01). In patients with VF (−), that is, asymptomatic Brugada syndrome, new VF occurrences, family history, or inducible VF showed a higher score than in those without these occurrences (p<0.01). Conclusion: The ST elevation score in VP-ECG objectively documented the degree of ST elevation in surface ECG in Brugada-type ECG patterns. The ST-elevation score might be useful for risk stratification in patients with asymptomatic Brugada syndrome.