Coexistence of atrioventricular accessory pathways and drug-induced type 1 Brugada pattern

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dc.contributor.authorHasdemir, Can
dc.contributor.authorJuang, Jimmy Jyh-Ming
dc.contributor.authorKose, Sedat
dc.contributor.authorKocabas, Umut
dc.contributor.authorOrman, Mehmet N.
dc.contributor.authorPayzin, Serdar
dc.contributor.authorSahin, Hatice
dc.contributor.authorCelen, Candan
dc.contributor.authorOzcan, Emin E.
dc.contributor.authorChen, Ching-Yu Julius
dc.contributor.authorGunduz, Ramazan
dc.contributor.authorTuran, Oguzhan E.
dc.contributor.authorSenol, Oktay
dc.contributor.authorBurashnikov, Elena
dc.contributor.authorAntzelevitch, Charles
dc.date.accessioned2019-10-27T10:02:55Z
dc.date.available2019-10-27T10:02:55Z
dc.date.issued2018
dc.departmentEge Üniversitesien_US
dc.description.abstractBackgroundAtrial arrhythmias, particularly atrioventricular nodal reentrant tachycardia, can coexist with drug-induced type 1 Brugada electrocardiogram (ECG) pattern (DI-Type1-BrP). The present study was designed to determine the prevalence of DI-Type1-BrP in patients with atrioventricular accessory pathways (AV-APs) and to investigate the clinical, electrocardiographic, electrophysiologic, and genetic characteristics of these patients. MethodsOne-hundred twenty-four consecutive cases of AV-APs and 84 controls underwent an ajmaline challenge test to unmask DI-Type1-BrP. Genetic screening and analysis was performed in 55 of the cases (19 with and 36 without DI-Type1-BrP). ResultsPatientswith AV-APs were significantly more likely than controls to have a Type1-BrP unmasked (16.1vs 4.8%, P=0.012). At baseline, patients with DI-Type1-BrP had higher prevalence of chest pain, QR/rSr' pattern in V-1 and QRS notching/slurring in V-2 and aVL during preexcitation, rSr' pattern in V-1-V-2, and QRS notching/slurring in aVL during orthodromic atrioventricular reentrant tachycardia (AVRT) compared to patients without DI-Type1-BrP. Abnormal QRS configuration (QRS notching/slurring and/or fragmentation) in V-2 during preexcitation was present in all patients with DI-Type1 BrP. The prevalence of spontaneous preexcited atrial fibrillation (AF) and history of AF were similar (15%vs 18.3%, P=0.726) in patients with and without DI-Type1-BrP, respectively. The prevalence of mutations in Brugada-susceptibility genes was higher (36.8%vs 8.3%, P=0.02) in patients with DI-Type1-BrP compared to patients without DI-Type1-BrP. ConclusionsDI-Type1-BrP is relatively common in patients with AV-APs. We identify 12-lead ECG characteristics during preexcitation and orthodromic AVRT that point to an underlying type1-BrP, portending an increased probability for development of malignant arrhythmias.en_US
dc.description.sponsorshipNIHUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [HL47678]; Wistar and Martha Morris fund; National Taiwan University Hospital, National Taiwan University [NTUH106-S3469, NTUH106-S3458, NTUH 105-012, NTUH 106-018, NTUH 105-S2995]; Ministry of Science and TechnologyMinistry of Education, Culture, Sports, Science and Technology, Japan (MEXT) [MOST 104 - 2314 - B - 002 - 193 - MY3, MOST 106-2314-B-002 -047 -MY3, MOST 106-2314-B-002 -134 -MY2, MOST 106-2314-B-002-206]; Taiwan Health Foundationen_US
dc.description.sponsorshipWe acknowledge support from the NIH (Grant # HL47678) and from the Wistar and Martha Morris fund. Financial support for this research was also provided partially through grants NTUH106-S3469, NTUH106-S3458, NTUH 105-012, NTUH 106-018, and NTUH 105-S2995 from National Taiwan University Hospital, National Taiwan University, and MOST 104 - 2314 - B - 002 - 193 - MY3, MOST 106-2314-B-002 -047 -MY3, MOST 106-2314-B-002 -134 -MY2 and MOST 106-2314-B-002-206 from the Ministry of Science and Technology and Taiwan Health Foundation.en_US
dc.identifier.doi10.1111/pace.13414en_US
dc.identifier.endpage1092en_US
dc.identifier.issn0147-8389
dc.identifier.issn1540-8159
dc.identifier.issue9en_US
dc.identifier.pmid29953624en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage1078en_US
dc.identifier.urihttps://doi.org/10.1111/pace.13414
dc.identifier.urihttps://hdl.handle.net/11454/30054
dc.identifier.volume41en_US
dc.identifier.wosWOS:000444469600005en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherWileyen_US
dc.relation.ispartofPace-Pacing and Clinical Electrophysiologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectatrioventricular reentrant tachycardiaen_US
dc.subjectBrugada syndromeen_US
dc.subjectgeneticsen_US
dc.subjectpreexcitationen_US
dc.subjectWolff-Parkinson-White syndromeen_US
dc.titleCoexistence of atrioventricular accessory pathways and drug-induced type 1 Brugada patternen_US
dc.typeArticleen_US

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