A New Approach for the Comparison of Conduction Abnormality between Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia and Brugada Syndrome

Abstract

Background: Right ventricular outflow tract ventricular tachycardia (RVOT‐VT), arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/ARVD), and Brugada syndrome (BrS) were characterized by arrhythmias originating in the right ventricle, and the pathophysiologic mechanism underlying these arrhythmias has not been fully understood.

Methods: This study consisted of 40 subjects, including 20 patients with RVOT‐VT, 10 patients with BrS, and 10 ARVD patients. The parameters on the signal‐averaged electrocardiography (ECG) and the frequency components recorded from the wavelet‐transformed ECG were compared between the three groups. Late potentials were positive in none of the patients with RVOT‐VT, seven of the patients with BrS, and all of ARVD patients.

Results: In Brugada and ARVD patients, the power of high‐frequency components (80–150 Hz) was developed to a greater extent than in RVOT‐VT patients. In the power analysis of the high‐frequency components between BrS and ARVD, the frequency showing the greatest power was significantly higher in ARVD patients than that in BrS patients (145.4 ± 27.9 Hz vs 81.7 ± 19.9 Hz, P < 0.01).

Conclusions: High‐frequency components were developed in ARVD and BrS, but not in RVOT‐VT. The frequency levels showing high power by wavelet analysis obviously differ between ARVD and BrS. Wavelet analysis may provide new insight into unsolved mechanisms in arrhythmogenic right heart disease.

Ann Noninvasive Electrocardiol 2011;16(3):263–269