Right bundle branch block, right precordial st-segment elevation, and sudden death in young people. Circulation. [Circulation] Journal article | | Title | Right bundle branch block, right precordial st-segment elevation, and sudden death in young people. | | Author(s) | Corrado D, Basso C, Buja G, Nava A, Rossi L, Thiene G | | Institution | Department of Cardiology, University of Padua Medical School, Padua, Italy. | | Source | Circulation 2001 Feb 6; 103(5):710-7. | | MeSH | Adult
Arrhythmia
Arrhythmogenic Right Ventricular Dysplasia
Comparative Study
Death, Sudden, Cardiac
Electrocardiography
Female
Humans
Italy
Male
Prevalence
Research Support, Non-U.S. Gov't
| | Abstract | BACKGROUND: Patients with the ECG pattern of right bundle branch block and right precordial ST-segment elevation may experience sudden death in the setting of either arrhythmogenic right ventricular cardiomyopathy (ARVC) or a functional electrical disorder such as Brugada syndrome.
METHODS AND RESULTS: Among a series of 273 young (</=35 years) victims of cardiovascular sudden death who were prospectively studied from 1979 to 1998 in the Veneto Region of Italy, 12-lead ECG was available in 96 cases. Thirteen (14%; 12 males and 1 female aged 24+/-8 years) had right precordial ST-segment elevation, either isolated (9 cases) or associated with right bundle branch block (4 cases). At autopsy, all patients had ARVC (92%) except one, who had no evidence of structural heart disease. Compared with the 19 young sudden death victims with ARVC and no ST-segment abnormalities from the same series, those with AVRC and right precordial ST-segment elevation included fewer competitive athletes (17% versus 58%; P:=0.03), more often died suddenly at rest or during sleep (83% versus 26%; P:=0.003), and showed serial ECG changes over time (83% versus 0; P:=0.015), polymorphic ventricular tachycardia (33% versus 0; P:=0.016), and predominant fatty replacement of the right ventricular anterior wall (58% versus 21%; P:=0.05),
CONCLUSIONS: Right precordial ST-segment elevation was found in 14% of young sudden death victims with available ECG. It mostly reflected underlying ARVC with predominant right ventricular anterior wall involvement and characterized a subgroup of patients who share with Brugada patients the propensity to die from non-exercise-related cardiac arrest and to exhibit dynamic ECG changes and polymorphic ventricular tachycardia. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 11156883 |
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