Validation and clinical implications of higher intercostal space electrocardiography in the patient with Brugada syndrome in Taiwan (SADS-TW BrS registry)
Background: Diagnosis of Brugada syndrome (BrS) is based on type 1 morphology (coved type) in electrocardiograms from standard (4th) or higher (2nd or 3rd) intercostal spaces (ICSs). However, the clinical implications of being diagnosed only at higher ICSs remains poorly understood. We aimed to inve...
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Elsevier
2025-06-01
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| Series: | Journal of the Formosan Medical Association |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664624005643 |
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| author | Hsinyu Tseng Mu-Ying Kuo Chia-Chi Chu Chiu-Ling Lai Chu-Chun Huang Hsiao-Ni Yan Jimmy Jyh-Ming Juang |
| author_facet | Hsinyu Tseng Mu-Ying Kuo Chia-Chi Chu Chiu-Ling Lai Chu-Chun Huang Hsiao-Ni Yan Jimmy Jyh-Ming Juang |
| author_sort | Hsinyu Tseng |
| collection | DOAJ |
| description | Background: Diagnosis of Brugada syndrome (BrS) is based on type 1 morphology (coved type) in electrocardiograms from standard (4th) or higher (2nd or 3rd) intercostal spaces (ICSs). However, the clinical implications of being diagnosed only at higher ICSs remains poorly understood. We aimed to investigate the diagnostic accuracy of higher ICS leads in the Taiwanese Brugada syndrome population and clarify if there is any difference in clinical presentation. Method: Patients enrolled in the Sudden Arrhythmic Death Syndrome-Taiwan (SADS-TW) registry from 2010/01/01 to 2021/07/30 were retrospectively reviewed. Records were examined for 163 patients whose ECGs in the 2nd, 3rd, and/or 4th ICSs showed a type 1 BrS pattern in at least 1 lead. Baseline characteristics, family history, clinical presentation, SCN5A mutation status, cardiovascular events, and mortality were analyzed. Result: Using the standard ICS alone, 56.4% patients could be diagnosed with BrS, whereas the remaining 43.6% of patients could only be diagnosed using higher ICSs. The mean age of diagnosis using higher ICSs was 42.2 ± 14.7 years vs. 46.8 ± 14.6 years in patients diagnosed using the standard ICSs (p = 0.048). Hypertension was more prevalent in patients diagnosed by standard ICSs (27.2%) vs. patients diagnosed by higher ICSs (4.2%; p < 0.001). No differences were observed in family history, clinical presentation, SCN5A mutation status, cardiovascular events, or mortality (mean follow-up time = 3.96 ± 3.45 years, p = 0.28). Conclusion: Using higher intercostal leads could significantly increase the diagnosis rate of BrS in the Taiwanese population, although it would not affect the clinical prognosis. |
| format | Article |
| id | doaj-art-e2f5f7ebc8704fc0a455de2100bb8154 |
| institution | OA Journals |
| issn | 0929-6646 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj-art-e2f5f7ebc8704fc0a455de2100bb81542025-08-20T01:59:14ZengElsevierJournal of the Formosan Medical Association0929-66462025-06-01124650851310.1016/j.jfma.2024.12.005Validation and clinical implications of higher intercostal space electrocardiography in the patient with Brugada syndrome in Taiwan (SADS-TW BrS registry)Hsinyu Tseng0Mu-Ying Kuo1Chia-Chi Chu2Chiu-Ling Lai3Chu-Chun Huang4Hsiao-Ni Yan5Jimmy Jyh-Ming Juang6Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine National Taiwan University Taipei, TaiwanDepartment of Laboratory Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Laboratory Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Laboratory Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Laboratory Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Laboratory Medicine, National Taiwan University Hospital, Taipei, TaiwanCardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Corresponding author. Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, No.7, Chung Shan S. Rd, Zhongzheng Dist., Taipei, 10002, Taiwan.Background: Diagnosis of Brugada syndrome (BrS) is based on type 1 morphology (coved type) in electrocardiograms from standard (4th) or higher (2nd or 3rd) intercostal spaces (ICSs). However, the clinical implications of being diagnosed only at higher ICSs remains poorly understood. We aimed to investigate the diagnostic accuracy of higher ICS leads in the Taiwanese Brugada syndrome population and clarify if there is any difference in clinical presentation. Method: Patients enrolled in the Sudden Arrhythmic Death Syndrome-Taiwan (SADS-TW) registry from 2010/01/01 to 2021/07/30 were retrospectively reviewed. Records were examined for 163 patients whose ECGs in the 2nd, 3rd, and/or 4th ICSs showed a type 1 BrS pattern in at least 1 lead. Baseline characteristics, family history, clinical presentation, SCN5A mutation status, cardiovascular events, and mortality were analyzed. Result: Using the standard ICS alone, 56.4% patients could be diagnosed with BrS, whereas the remaining 43.6% of patients could only be diagnosed using higher ICSs. The mean age of diagnosis using higher ICSs was 42.2 ± 14.7 years vs. 46.8 ± 14.6 years in patients diagnosed using the standard ICSs (p = 0.048). Hypertension was more prevalent in patients diagnosed by standard ICSs (27.2%) vs. patients diagnosed by higher ICSs (4.2%; p < 0.001). No differences were observed in family history, clinical presentation, SCN5A mutation status, cardiovascular events, or mortality (mean follow-up time = 3.96 ± 3.45 years, p = 0.28). Conclusion: Using higher intercostal leads could significantly increase the diagnosis rate of BrS in the Taiwanese population, although it would not affect the clinical prognosis.http://www.sciencedirect.com/science/article/pii/S0929664624005643Brugada syndromeHigher intercostal leadsElectrocardiogramSADS-TW BrS |
| spellingShingle | Hsinyu Tseng Mu-Ying Kuo Chia-Chi Chu Chiu-Ling Lai Chu-Chun Huang Hsiao-Ni Yan Jimmy Jyh-Ming Juang Validation and clinical implications of higher intercostal space electrocardiography in the patient with Brugada syndrome in Taiwan (SADS-TW BrS registry) Journal of the Formosan Medical Association Brugada syndrome Higher intercostal leads Electrocardiogram SADS-TW BrS |
| title | Validation and clinical implications of higher intercostal space electrocardiography in the patient with Brugada syndrome in Taiwan (SADS-TW BrS registry) |
| title_full | Validation and clinical implications of higher intercostal space electrocardiography in the patient with Brugada syndrome in Taiwan (SADS-TW BrS registry) |
| title_fullStr | Validation and clinical implications of higher intercostal space electrocardiography in the patient with Brugada syndrome in Taiwan (SADS-TW BrS registry) |
| title_full_unstemmed | Validation and clinical implications of higher intercostal space electrocardiography in the patient with Brugada syndrome in Taiwan (SADS-TW BrS registry) |
| title_short | Validation and clinical implications of higher intercostal space electrocardiography in the patient with Brugada syndrome in Taiwan (SADS-TW BrS registry) |
| title_sort | validation and clinical implications of higher intercostal space electrocardiography in the patient with brugada syndrome in taiwan sads tw brs registry |
| topic | Brugada syndrome Higher intercostal leads Electrocardiogram SADS-TW BrS |
| url | http://www.sciencedirect.com/science/article/pii/S0929664624005643 |
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