Tpeak-Tend interval and Tpeak-T end/QT ratio as markers of ventricular tachycardia inducibility in subjects with Brugada ECG phenotype

Abstract

Aims The present study investigated whether several ECG markers of ventricular repolarization are associated with ventricular tachycardia/ fibrillation (VT/VF) inducibility in subjects with type 1 ECG pattern of Brugada syndrome (BS). Methods and results The clinical data of 23 individuals (19 males, age 42.69 ± 14.63) with spontaneous (n = 10) or drug-induced (n = 13) type 1 ECG pattern of BS who underwent programmed ventricular stimulation were analysed. Sustained VT/VF was induced in 17 subjects (74) and was significantly associated with the presence of spontaneous type 1 ECG of BS (P = 0.012). Among the studied ECG repolarization markers, subjects with inducible VT/VF displayed an increased Tpeak-Tend interval in leads V2 (88.82 ± 15.70 vs. 78.33 ± 4.08 ms, P = 0.02) and V6 (76.33 ± 10.08 vs. 66.66 ± 5.16 ms, P = 0.04) and a greater Tpeak-Tend/QT ratio in lead V6 (0.214 ± 0.028 vs. 0.180 ± 0.014, P = 0.009) compared with those without arrhythmias. Ventricular tachycardia/fibrillation inducibility was not associated with arrhythmic events during a mean follow-up period of 4.61 ± 2.14 years (P = 0.739). Conclusion The Tpeak-Tend interval and Tpeak-Tend/QT ratio were associated with VT/VF inducibility in BS. The utility of Tpeak-Tend/QT ratio as a new marker of arrhythmogenesis in BS requires further studies, including a large number of patients.