High prevalence of concealed Brugada syndrome in patients with atrioventricular nodal reentrant tachycardia

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dc.contributor.authorHasdemir, Can
dc.contributor.authorPayzin, Serdar
dc.contributor.authorKocabas, Umut
dc.contributor.authorSahin, Hatice
dc.contributor.authorYildirim, Nihal
dc.contributor.authorAlp, Alpay
dc.contributor.authorAydin, Mehmet
dc.contributor.authorPfeiffer, Ryan
dc.contributor.authorBurashnikov, Elena
dc.contributor.authorWu, Yuesheng
dc.contributor.authorAntzelevitch, Charles
dc.date.accessioned2019-10-27T22:59:34Z
dc.date.available2019-10-27T22:59:34Z
dc.date.issued2015
dc.departmentEge Üniversitesien_US
dc.description.abstractBACKGROUND Atrioventricular nodal reentrant tachycardia (AVNRT) may coexist with Brugada syndrome (BrS). OBJECTIVES The present study was designed to determine the prevalence of drug-induced type 1 Brugada ECG pattern (concealed BrS) in patients presenting with clinical spontaneous AVNRT and to investigate their electrocardiographic, electrophysiological, and genetic characteristics. METHODS Ninety-six consecutive patients without any sign of BrS on baseline electrocardiogram undergoing electrophysiological study and ablation for symptomatic, drug-resistant AVNRT and 66 control subjects underwent an ajmaline challenge to unmask BrS. Genetic screening was performed in 17 patients displaying both AVNRT and BrS. RESULTS A concealed BrS electrocardiogram was uncovered in 26 of 96 patients with AVNRT (27.1%) and in 3 of 66 control subjects (4.5%) (P <= .001). Patients with concealed BrS were predominantly female patients (n = 23 [88.5%] vs n = 44 [62.9%], P = .015), had higher prevalence of chest pain (n = 10 [38.5%] vs n = 13 [18.6%], p = 0.042), migraine headaches (n = 10 [38.5%] vs n = 10 [14.2%], p = 0.008), and drug-induced initiation and/or worsening of duration and/or frequency of AVNRT (n = 4 [15.4%] vs n = 1 [1.4%], p = 0.006) as compared to patients with AVNRT without BrS. Genetic screening identified 19 mutations or rare variants in 13 genes in 13 of 17 patients with both AVNRT and BrS (yield = 76.5%). Ten of these 13 genotype-positive patients (76.9%) harbored genetic variants known or suspected to cause a loss of function of cardiac sodium channel current (SCN5A, SCN10A, SCN1B, GPD1L, PKP2, and HEY2). CONCLUSION Our results suggest that spontaneous AVNRT and concealed BrS co-occur, particularly in female patients, and that genetic variants that reduce sodium channel current may provide a mechanistic link between AVNRT and BrS and predispose to expression of both phenotypes.en_US
dc.description.sponsorshipNational Heart, Lung, and Blood Institute of the National Institutes of HealthUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USANIH National Heart Lung & Blood Institute (NHLBI) [HL47678]; Mason of New York; Mason of Florida; Mason of Massachusetts; Mason of Connecticut; Mason of Maryland; Mason of Delaware; Mason of Rhode Island; Mason of New Hampshire; Mason of Wisconsinen_US
dc.description.sponsorshipThis study was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health (grant no. HL47678, to Dr Antzelevitch) and the Masons of New York, Florida, Massachusetts, Connecticut, Maryland, Delaware, Rhode Island, New Hampshire, and Wisconsin.en_US
dc.identifier.doi10.1016/j.hrthm.2015.03.015en_US
dc.identifier.endpage1594en_US
dc.identifier.issn1547-5271
dc.identifier.issn1556-3871
dc.identifier.issue7en_US
dc.identifier.pmid25998140en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage1584en_US
dc.identifier.urihttps://doi.org/10.1016/j.hrthm.2015.03.015
dc.identifier.urihttps://hdl.handle.net/11454/51826
dc.identifier.volume12en_US
dc.identifier.wosWOS:000356766500034en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevier Science Incen_US
dc.relation.ispartofHeart Rhythmen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectBrugada syndromeen_US
dc.subjectAtrioventricular nodal reentrant tachycardiaen_US
dc.subjectSupraventricular tachycardiaen_US
dc.subjectGeneticsen_US
dc.titleHigh prevalence of concealed Brugada syndrome in patients with atrioventricular nodal reentrant tachycardiaen_US
dc.typeArticleen_US

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