[SCD-FORUM] 30E RE: Asymptomatic patient with Brugada syndrome. Dr. Perez Riera

[SCD Symposium]

Dear Dr. Sunil Roy.  MD, DM from India. Here Andres Ricardo Perez
Riera. You asked to Ramon Brugada about if is there any role for
microvolt T wave alternans for risk stratifications and to decide the
need for ICD?

T wave alternans (TWA) does not assess arrhythmic risk in patients with
Brugada syndrome (BrS). It is not an appropriate test to detect
arrhythmic risk in patients with BrS (1).

Ikeda et al. enrolled 124 consecutive subjects with a Brugada-type ECG.
Prognostic indices included: age, sex, a family history of SD, syncopal
episodes, a spontaneous Type 1 ST-segment elevation, maximal magnitude
of ST-segment elevation, a spontaneous change in ST segment, a mean
QRSd, maximal QT interval, QT dispersion, LPs by SA-ECG, and TWA. Of the
12 risk indices, only a family history of SD, syncopal episodes, a
spontaneous type 1 ST-segment elevation, a spontaneous change in ST
segment, and LP had significant values (2).TWA does not assess
arrhythmic risk

References
1)          Kirchhof P,  Eckardt L,  Rolf S, T wave alternans does not
assess arrhythmic risk in patients with Brugada syndrome.   Ann
Noninvasive Electrocardiol. 2004;9:162-165.20
2)           Ikeda T, Takami M, Sugi K, et al. Noninvasive risk
stratification of subjects with a Brugada-type electrocardiogram and no
history of cardiac arrest. 20
All the best
AndrE9s Ricardo PE9rez Riera20
Chief of Electro-Vectocardiology Sector of the Discipline of
Cardiology,ABC Faculty of Medicine (FMABC), Foundation of ABC (FUABC)-
Santo AndrE9 -SE3o Paulo - Brazil. Rua SebastiE3o Afonso  885 - Zip
Code: 044417-100- Jardim Miriam  S.P.- Brazil - Phone: 5504-6243  Fax:
5506-0398.

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee




El 14/10/2006, a las 9:09, SCD Symposium escribió:

> Forum of the ISHNE Sudden Cardiac Death World-Wide Internet Symposium
> ______________________________________________________________________
>
> SCD-HeFT trial shows ICD therapy mortality benefit:
> http://www.scdheft.com
> ______________________________________________________________________
>
> Dear Dr. Ramon Brugada,
> As you have discussed in the answer to the question for an  
> asymptomatic
> patient with brugada syndrome, the use of EPS to risk stratify
> asymptomatic patient is very controversial. The first symptom may be
> sudden death in such patients. In such a scenario is there any role  
> for
> microvolt T wave alternans for risk stratifications and to decide  
> the need
> for ICD?
>
> Dr. Sunil Roy.  MD, DM
> Senior Lecturer in Cardiology
> Medical college, Calicut, Kerala, India
> Email: sunilroytn at calicutmedicalcollege.ac.in
>
>
> --
> Dr. Sergio Dubner
> President of Scientific Committee
>
> Dr. Edgardo Schapachnik
> President of Steering Committee
>
>
>
>
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