Late potentials assessment - an useful tool for Brugada Syndrome risk stratification

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Brugada syndrome (BrS) is a channelopathy confining an increased risk sudden cardiac death (SCD). Asymptomatic patients (pts) management remains challenging enhancing the necessity for additionally stratification tools. Purpose To evaluate role non-invasive assessment late potentials (LP) based on SA-ECG as tools in BrS cohort. Methods Prospective, observational single-center study pts with following criteria (1) 1 ECG pattern, either spontaneous or drug induced; (2) performed before anti-arrhythmic treatment; (3) minimum follow up duration 12 months. LPs were evaluated by determination total filtered QRS (fQRS); root mean square voltage 40ms terminal portion (RMS40) and low amplitude electric potential component (LAS40) conventional modified right precordial leads. Malignant arrhythmic events (MAEs) defined composite event SCD appropriate ICD shocks. Association relevant factors MAE was conducted Univariate Cox regression analysis, well continuous categorical divided standard cut-offs (fQRS >114ms, RMS40<20µV, LAS40>38ms). A score predicting computed incorporating significant variables. Results 106 fulfilled inclusion (mean age: 48 ± years, 67.9% male), 52 (49.1%) type pattern. The majority asymptomatic at baseline (81.1%) while 13 presented syncope 3 polymorphic VT/cardiac arrest. 10 (7.1%) MAEs documented during 4.7 years - 4 6 Clinical presentation arrest (p <0.001) LP predictors univariate except RMS40 Neither common (male gender, pattern baseline, previous presence pathogenic SCN5A mutation) follow-up– figure 1. Positive cut-offs, all variables leads, significantly associated follow-up – 2. 2 positive represented 4.7-fold (HR 4.693, 95% CI 1.506-14.624, p = 0.008) Conclusion noninvasive SAECG represent useful prognostic tool BrS. identified subset higher who may deserve individualized preventive strategies.