Rhythmic Risk of Type 1 Brugada Syndrome and Pulmonary Infundibulum Mapping

Hospices Civils de Lyon10 enrolled

Overview

Brugada syndrome has been described as the association of a right bundle block with ST segment elevation on the V1 to V3 electrocardiogram in patients with a structurally normal heart. The rhythmic risk is thus difficult to evaluate in asymptomatic patients in whom the rate of events is estimated at 0.2 to 1.4% of events per year. In addition, the predictive value of ventricular pacing remains controversial; There is therefore currently no review to effectively assess rhythmic risk in patients with Brugada type I syndrome. Investigators aimed to show a difference in pulmonary infundibulum voltage mapping in symptomatic and asymptomatic patients with Brugada type 1 syndrome with a comparable ECG. The mapping of the pulmonary infundibulum will be performed during electrophysiological exploration. Only the catheter used differs from the usual procedure.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

OTHER

Masking

NONE

Enrollment

Conditions

Brugada Syndrome Type 1

Interventions

Eligibility

Sex: ALLMin age: 18 Months

Medical Language ↔ Plain English

Inclusion Criteria: Group 21 * Brugada Type 1 syndrome * Age : 50-60 years old * Asymptomatic * Signed informed consent Group2 * Brugada Type 1 syndrome * Age \>18 years old * Implantable defibrillator * Having received at least 1 appropriate shock or a sudden sudden death * Signed informed consent Groups 1 and 2 Exclusion Criteria: * Brugada Type 2 or 3 syndrome * Contraindication to electrophysiological exploration

Outcomes

Primary Outcomes

Identification of different voltage zones by endocardial mapping of the pulmonary infundibulum between asymptomatic patients with Brugada type 1 and patients with symptomatic Brugada type 1

The voltage zone are defined with : * measurement of unipolar and bipolar local voltage (mV) * the scar surface * the surface of the bordering area * the surface of healthy tissue * the quantification of the number of fractionated potentials and density with respect to the size of the infundibulum and the scar (if present) * the analysis of the heterogeneity of the voltage (study of dispersion) * analysis of propagation card velocities in sinus rhythm and ventricular pacing (mm / s) * analysis of ventricular arrhythmia activation if positive ventricular pacing and good hemodynamic tolerance (focal / reentrant / reentrant macro).

Time frame: Day 1

Central Contacts

Philippe CHEVALIER, MD PhD, Pr

CONTACT

4 72 35 70 27 philippe.morel@chu-lyon.fr

Elodie MOREL, CRA