Local dispersion of repolarization in the occurrence of ventricular fibrillation in Brugada syndrome: Possibility of phase 2 reentry?

Pacing Clin Electrophysiol. 2024 Aug;47(8):1049-1053. doi: 10.1111/pace.14917. Epub 2024 Jan 12.

Abstract

To date, there have been no reports of recording epicardial electrograms at the onset of spontaneous ventricular fibrillation (VF) in patients with Brugada syndrome (BrS). In the case of BrS, unipolar and bipolar electrogram recording on the right ventricular epicardium revealed that dispersion of repolarization with delayed potential was associated with spontaneous occurrence of VF. Phase 2 reentry associated with shortening and dispersion of action potential could have been recorded for the first time in BrS. Epicardial unipolar mapping can guide accurate and appropriate ablation for the elimination of arrhythmia substrate in J wave syndrome.

Keywords: Brugada syndrome; J wave syndrome; phase 2 reentry; repolarization; ventricular fibrillation.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Brugada Syndrome* / complications
  • Brugada Syndrome* / physiopathology
  • Electrocardiography*
  • Epicardial Mapping
  • Heart Conduction System / physiopathology
  • Humans
  • Male
  • Ventricular Fibrillation* / physiopathology