Hasdemir, CanJuang, Jimmy Jyh-MingKose, SedatKocabas, UmutOrman, Mehmet N.Payzin, SerdarSahin, HaticeCelen, CandanOzcan, Emin E.Chen, Ching-Yu JuliusGunduz, RamazanTuran, Oguzhan E.Senol, OktayBurashnikov, ElenaAntzelevitch, Charles2019-10-272019-10-2720180147-83891540-8159https://doi.org/10.1111/pace.13414https://hdl.handle.net/11454/30054BackgroundAtrial 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.en10.1111/pace.13414info:eu-repo/semantics/openAccessatrioventricular reentrant tachycardiaBrugada syndromegeneticspreexcitationWolff-Parkinson-White syndromeArticle41910781092WOS:00044446960000529953624Q2Q4