Abnormal restitution property of action potential duration and conduction delay in Brugada syndrome: both repolarization and depolarization abnormalities

作者：Nishii Nobuhiro^*; Nagase Satoshi; Morita Hiroshi; Kusano Kengo Fukushima; Namba Tsunetoyo; Miura Daiji; Miyaji Kohei; Hiramatsu Shigeki; Tada Takeshi; Murakami Masato; Watanabe Atsuyuki; Banba Kimikazu; Sakai Yoshiaki; Nakamura Kazufumi; Oka Takefumi; Ohe Tohru

来源：Europace, 2010, 12(4): 544-552.

DOI：10.1093/europace/eup432

• Brugada syndrome
• Ventricular fibrillation
• Monophasic action potential duration
• Restitution curve
• Conduction delay

Aims This study sought to examine the action potential duration restitution (APDR) property and conduction delay in Brugada syndrome (BrS) patients. A steeply sloped APDR curve and conduction delay are known to be important determinants for the occurrence of ventricular fibrillation (VF).
Methods and results Endocardial monophasic action potential was obtained from 39 BrS patients and 9 control subjects using the contact electrode method. Maximum slopes of the APDR curve were obtained at both the right ventricular outflow tract (RVOT) and the right ventricular apex (RVA). The onset of activation delay (OAD) after premature stimulation was examined as a marker of conduction delay. Maximum slope of the APDR curve in BrS patients was significantly steeper than that in control subjects at both the RVOT and the RVA (0.77 +/- 0.21 vs. 058 +/- 0.14 at RVOT, P = 0.009; 0.98 +/- 0.23 vs. 0.62 +/- 0.16 at RVA, P = 0.001). The dispersion of maximum slope of the APDR curve between the RVOT and the RVA was also larger in BrS patients than in control subjects. The OAD was significantly longer in BrS patients than in control subjects from the RVOT to RVA and from the RVA to RVOT (from RVOT to RVA: 256 +/- 12 vs. 243 +/- 7 ms, P = 0.003; from RVA to RVOT: 252 +/- 11 vs. 241 +/- 9 ms, P = 0.01).
Conclusions Abnormal APDR properties and conduction delay were observed in BrS patients. Both repolarization and depolarization abnormalities are thought to be related to the development of VF in BrS patients.

• 出版日期2010-4