Abstract
Prominent J waves are encountered in a number of life-threatening cardiac arrhythmia syndromes, including the Brugada (BrS) and early repolarization (ERS) syndromes. BrS and ERS differ with respect to the magnitude and lead location of abnormal J waves and are thought to represent a continuous spectrum of phenotypic expression termed J wave syndromes. Both are associated with the development of polymorphic ventricular tachycardia (VT) and ventricular fibrillation (VF) leading to sudden cardiac death (SCD) in young adults. J wave syndromes are characterized by J-onset and ST-elevation in distinct ECG-leads. The region most affected by BrS is the anterior right ventricular outflow tract, accounting for why J-onset and ST-segment elevation are limited to the right precordial leads. The region most affected in ERS is the inferior wall of the left ventricle, accounting for why the appearance of J waves or early repolarization in the inferior ECG leads is associated with the highest risk for development of arrhythmias and SCD. Risk stratification and the approach to therapy of the J wave syndromes continue to be mired in controversy. Our objective in this chapter is to provide an integrated review of the clinical characteristics, risk stratifiers, as well as the molecular, ionic, cellular and genetic mechanisms underlying the J wave syndromes.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Osborn JJ. Experimental hypothermia: respiratory and blood pH changes in relation to cardiac function. Am J Physiol. 1953;175:389–98.
Clements SD, Hurst JW. Diagnostic value of ECG abnormalities observed in subjects accidentally exposed to cold. Am J Cardiol. 1972;29:729–34.
Thompson R, Rich J, Chmelik F, Nelson WL. Evolutionary changes in the electrocardiogram of severe progressive hypothermia. J Electrocardiol. 1977;10:67–70.
Eagle K. Images in clinical medicine. Osborn waves of hypothermia. N Engl J Med. 1994;10:680.
Kraus F. Ueber die wirkung des kalziums auf den kreislauf 1. Dtsch Med Wochenschr. 1920;46:201–3.
Sridharan MR, Horan LG. Electrocardiographic J wave of hypercalcemia. Am J Cardiol. 1984;54:672–3.
Antzelevitch C, Yan GX. J wave syndromes. Heart Rhythm. 2010;7:549–58.
Hugo N, Dormehl IC, Van Gelder AL. A positive wave at the J-point of electrocardiograms of anaesthetized baboons. J Med Primatol. 1988;17:347–52.
West TC, Frederickson EL, Amory DW. Single fiber recording of the ventricular response to induced hypothermia in the anesthetized dog. Correlation with multicellular parameters. Circ Res. 1959;7:880–8.
Santos EM, Frederick KC. Electrocardiographic changes in the dog during hypothermia. Am Heart J. 1957;55:415–20.
Wasserburger RH, Alt WJ. The normal RS-T segment elevation variant. Am J Cardiol. 1961;8:184–92.
Mehta MC, Jain AC. Early repolarization on scalar electrocardiogram. Am J Med Sci. 1995;309:305–11.
Gussak I, Antzelevitch C. Early repolarization syndrome: clinical charactertics and possible cellular and ionic mechanisms. J Electrocardiol. 2000;33:299–309.
Yan GX, Antzelevitch C. Cellular basis for the Brugada syndrome and other mechanisms of arrhythmogenesis associated with ST segment elevation. Circulation. 1999;100:1660–6.
Shu J, Zhu T, Yang L, Cui C, Yan GX. ST-segment elevation in the early repolarization syndrome, idiopathic ventricular fibrillation, and the Brugada syndrome: cellular and clinical linkage. J Electrocardiol. 2005;38:26–32.
Bjerregaard P, Gussak I, Kotar S, Gessler JE. Recurrent synocope in a patient with prominent J-wave. Am Heart J. 1994;127:1426–30.
Yan GX, Antzelevitch C. Cellular basis for the electrocardiographic J wave. Circulation. 1996;93:372–9.
Geller JC, Reek S, Goette A, Klein HU. Spontaneous episode of polymorphic ventricular tachycardia in a patient with intermittent Brugada syndrome. J Cardiovasc Electrophysiol. 2001;12:1094.
Daimon M, Inagaki M, Morooka S, Fukuzawa S, Sugioka J, Kushida S, Tateno K, Ozawa S. Brugada syndrome characterized by the appearance of J waves. Pacing Clin Electrophysiol. 2000;23:405–6.
Kalla H, Yan GX, Marinchak R. Ventricular fibrillation in a patient with prominent J (Osborn) waves and ST segment elevation in the inferior electrocardiographic leads: a Brugada syndrome variant? J Cardiovasc Electrophysiol. 2000;11:95–8.
Komiya N, Imanishi R, Kawano H, Shibata R, Moriya M, Fukae S, Doi Y, Nakao K, Seto S, Yano K. Ventricular fibrillation in a patient with prominent J wave in the inferior and lateral electrocardiographic leads after gastrostomy. Pacing Clin Electrophysiol. 2006;29:1022–4.
Shinohara T, Takahashi N, Saikawa T, Yoshimatsu H. Characterization of J wave in a patient with idiopathic ventricular fibrillation. Heart Rhythm. 2006;3:1082–4.
Riera AR, Ferreira C, Schapachnik E, Sanches PC, Moffa PJ. Brugada syndrome with atypical ECG: downsloping ST-segment elevation in inferior leads. J Electrocardiol. 2004;37:101–4.
Haissaguerre M, Derval N, Sacher F, Jesel L, Deisenhofer I, De Roy L, Pasquie JL, Nogami A, Babuty D, Yli-Mayry S, De Chillou C, Scanu P, Mabo P, Matsuo S, Probst V, Le Scouarnec S, Defaye P, Schlaepfer J, Rostock T, Lacroix D, Lamaison D, Lavergne T, Aizawa Y, Englund A, Anselme F, O’Neill M, Hocini M, Lim KT, Knecht S, Veenhuyzen GD, Bordachar P, Chauvin M, Jais P, Coureau G, Chene G, Klein GJ, Clementy J. Sudden cardiac arrest associated with early repolarization. N Engl J Med. 2008;358:2016–23.
Nam GB, Kim YH, Antzelevitch C. Augmentation of J waves and electrical storms in patients with early repolarization. N Engl J Med. 2008;358:2078–9.
Rosso R, Kogan E, Belhassen B, Rozovski U, Scheinman MM, Zeltser D, Halkin A, Steinvil A, Heller K, Glikson M, Katz A, Viskin S. J-point elevation in survivors of primary ventricular fibrillation and matched control subjects: incidence and clinical significance. J Am Coll Cardiol. 2008;52:1231–8.
Tikkanen JT, Anttonen O, Junttila MJ, Aro AL, Kerola T, Rissanen HA, Reunanen A, Huikuri HV. Long-term outcome associated with early repolarization on electrocardiography. N Engl J Med. 2009;361:2529–37.
Sinner MF, Reinhard W, Muller M, Beckmann BM, Martens E, Perz S, Pfeufer A, Winogradow J, Stark K, Meisinger C, Wichmann HE, Peters A, Riegger GA, Steinbeck G, Hengstenberg C, Kaab S. Association of early repolarization pattern on ECG with risk of cardiac and all-cause mortality: a population-based prospective cohort study (MONICA/KORA). PLoS Med. 2010;7:e1000314.
Noseworthy PA, Tikkanen JT, Porthan K, Oikarinen L, Pietila A, Harald K, Peloso GM, Merchant FM, Jula A, Vaananen H, Hwang SJ, O’Donnell CJ, Salomaa V, Newton-Cheh C, Huikuri HV. The early repolarization pattern in the general population clinical correlates and heritability. J Am Coll Cardiol. 2011;57:2284–9.
Tikkanen JT, Junttila MJ, Anttonen O, Aro AL, Luttinen S, Kerola T, Sager SJ, Rissanen HA, Myerburg RJ, Reunanen A, Huikuri HV. Early repolarization: electrocardiographic phenotypes associated with favorable long-term outcome. Circulation. 2011;123:2666–73.
Gross GJ. Early repolarization and ventricular fibrillation: vagally familiar? Heart Rhythm. 2010;7:653–4.
Bastiaenen R, Hedley PL, Christiansen M, Behr ER. Therapeutic hypothermia and ventricular fibrillation storm in early repolarization syndrome. Heart Rhythm. 2010;7:832–4.
Mizumaki K, Nishida K, Iwamoto J, Nakatani Y, Yamaguchi Y, Sakamoto T, Tsuneda T, Inoue H, Sakabe M, Fujiki A. Early repolarization in Wolff-Parkinson-White syndrome: prevalence and clinical significance. Europace. 2011;13:1195–200.
Rosso R, Adler A, Halkin A, Viskin S. Risk of sudden death among young individuals with J waves and early repolarization: putting the evidence into perspective. Heart Rhythm. 2011;8:923–9.
Haruta D, Matsuo K, Tsuneto A, Ichimaru S, Hida A, Sera N, Imaizumi M, Nakashima E, Maemura K, Akahoshi M. Incidence and prognostic value of early repolarization pattern in the 12-lead electrocardiogram. Circulation. 2011;123:2931–7.
Shimizu W, Matsuo K, Kokubo Y, Satomi K, Kurita T, Noda T, Nagaya N, Suyama K, Aihara N, Kamakura S, Inamoto N, Akahoshi M, Tomoike H. Sex hormone and gender difference – role of testosterone on male predominance in Brugada syndrome. J Cardiovasc Electrophysiol. 2007;18:415–21.
Barajas-Martinez H, Hu D, Urrutia J, Wu Y, Panama BK, Goodrow RJ, Sicouri S, Di Diego JM, Treat JA, Desai M, Doss MX, Antzelevitch C. Chronic exposure to testosterone increases expression of transient outward current in human induced pluripotent stem cell (hiPSC)-derived cardiomyocytes (CM). Heart Rhythm. 2013;10:1741.
Di Diego JM, Cordeiro JM, Goodrow RJ, Fish JM, Zygmunt AC, Peréz GJ, Scornik FS, Antzelevitch C. Ionic and cellular basis for the predominance of the Brugada syndrome phenotype in males. Circulation. 2002;106:2004–11.
Nam GB, Ko KH, Kim J, Park KM, Rhee KS, Choi KJ, Kim YH, Antzelevitch C. Mode of onset of ventricular fibrillation in patients with early repolarization pattern vs Brugada syndrome. Eur Heart J. 2010;31:330–9.
Maury P, Rollin A, Sacher F, Gourraud JB, Raczka F, Pasquie JL, Duparc A, Mondoly P, Cardin C, Delay M, Derval N, Chatel S, Bongard V, Sadron M, Denis A, Davy JM, Hocini M, Jais P, Jesel L, Haissaguerre M, Probst V. Prevalence and prognostic role of various conduction disturbances in patients with the Brugada syndrome. Am J Cardiol. 2013;112:1384–9.
Antzelevitch C. J wave syndromes: molecular and cellular mechanisms. J Electrocardiol. 2013;46:510–8.
Mahida S, Derval N, Sacher F, Berte B, Yamashita S, Hooks DA, Denis A, Lim H, Amraoui S, Aljefairi N, Hocini M, Jais P, Haissaguerre M. History and clinical significance of early repolarization syndrome. Heart Rhythm. 2015;12:242–9.
Wellens HJ, Schwartz PJ, Lindemans FW, Buxton AE, Goldberger JJ, Hohnloser SH, Huikuri HV, Kaab S, La Rovere MT, Malik M, Myerburg RJ, Simoons ML, Swedberg K, Tijssen J, Voors AA, Wilde AA. Risk stratification for sudden cardiac death: current status and challenges for the futuredagger. Eur Heart J. 2014;35:1642–51.
Macfarlane PW, Antzelevitch C, Haissaguerre M et al. The Early Repolarization Pattern: A Consensus Paper. J Am Coll Cardiol 2015;66:470–7.
Brugada P, Brugada J. Right bundle branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome: a multicenter report. J Am Coll Cardiol. 1992;20:1391–6.
Kanter RJ, Pfeiffer R, Hu D, Barajas-Martinez H, Carboni MP, Antzelevitch C. Brugada-like syndrome in infancy presenting with rapid ventricular tachycardia and intraventricular conduction delay. Circulation. 2012;125:14–22.
Antzelevitch C. Molecular biology and cellular mechanisms of Brugada and long QT syndromes in infants and young children. J Electrocardiol. 2001;34:177–81.
Wedekind H, Smits JP, Schulze-Bahr E, Arnold R, Veldkamp MW, Bajanowski T, Borggrefe M, Brinkmann B, Warnecke I, Funke H, Bhuiyan ZA, Wilde AA, Breithardt G, Haverkamp W. De novo mutation in the SCN5A gene associated with early onset of sudden infant death. Circulation. 2001;104:1158–64.
Antzelevitch C. Brugada syndrome. Pacing Clin Electrophysiol. 2006;29:1130–59.
Coronel R, Casini S, Koopmann TT, Wilms-Schopman FJ, Verkerk AO, de Groot JR, Bhuiyan Z, Bezzina CR, Veldkamp MW, Linnenbank AC, van der Wal AC, Tan HL, Brugada P, Wilde AA, de Bakker JM. Right ventricular fibrosis and conduction delay in a patient with clinical signs of Brugada syndrome: a combined electrophysiological, genetic, histopathologic, and computational study. Circulation. 2005;112:2769–77.
Federman NJ, Mechulan A, Klein GJ, Krahn AD. Ventricular fibrillation induced by spontaneous hypothermia in a patient with early repolarization syndrome. J Cardiovasc Electrophysiol. 2013;24:586–8.
Nam GB. Idiopathic ventricular fibrillation, early repolarization and other J wave-related ventricular fibrillation syndromes. Circ J. 2012;76:2723–31.
McIntyre WF, Perez-Riera AR, Femenia F, Baranchuk A. Coexisting early repolarization pattern and Brugada syndrome: recognition of potentially overlapping entities. J Electrocardiol. 2012;45:195–8.
Kawata H, Noda T, Yamada Y, Okamura H, Satomi K, Aiba T, Takaki H, Aihara N, Isobe M, Kamakura S, Shimizu W. Effect of sodium-channel blockade on early repolarization in inferior/lateral leads in patients with idiopathic ventricular fibrillation and Brugada syndrome. Heart Rhythm. 2012;9:77–83.
Nakagawa K, Nagase S, Morita H, Ito H. Left ventricular epicardial electrogram recordings in idiopathic ventricular fibrillation with inferior and lateral early repolarization. Heart Rhythm. 2013;11:314–7.
Benito B, Sarkozy A, Mont L, Henkens S, Berruezo A, Tamborero D, Arzamendi D, Berne P, Brugada R, Brugada P, Brugada J. Gender differences in clinical manifestations of Brugada syndrome. J Am Coll Cardiol. 2008;52:1567–73.
Kamakura T, Kawata H, Nakajima I, Yamada Y, Miyamoto K, Okamura H, Noda T, Satomi K, Aiba T, Takaki H, Aihara N, Kamakura S, Kimura T, Shimizu W. Significance of non-type 1 anterior early repolarization in patients with inferolateral early repolarization syndrome. J Am Coll Cardiol. 2013;62:1610–8.
Aizawa Y, Sato A, Watanabe H, Chinushi M, Furushima H, Horie M, Kaneko Y, Imaizumi T, Okubo K, Watanabe I, Shinozaki T, Aizawa Y, Fukuda K, Joo K, Haissaguerre M. Dynamicity of the J-wave in idiopathic ventricular fibrillation with a special reference to pause-dependent augmentation of the J-wave. J Am Coll Cardiol. 2012;59:1948–53.
Nademanee K. Sudden unexplained death syndrome in southeast Asia. Am J Cardiol. 1997;79(6A):10–1.
Patel RB, Ng J, Reddy V, Chokshi M, Parikh K, Subacius H, Sheikh-Ali AA, Nguyen T, Link MS, Goldberger JJ, Ilkhanoff L, Kadish AH. Early repolarization associated with ventricular arrhythmias in patients with chronic coronary artery disease. Circ Arrhythm Electrophysiol. 2010;3:489–95.
Naruse Y, Tada H, Harimura Y, Hayashi M, Noguchi Y, Sato A, Yoshida K, Sekiguchi Y, Aonuma K. Early repolarization is an independent predictor of occurrences of ventricular fibrillation in the very early phase of acute myocardial infarctions. Circ Arrhythm Electrophysiol. 2012;5:506–13.
Furukawa Y, Yamada T, Morita T, Iwasaki Y, Kawasaki M, Kikuchi A, Naito T, Fujimoto T, Ozu K, Kondo T, Sengoku K, Yamamoto H, Masuyama T, Fukunami M. Early repolarization pattern associated with sudden cardiac death: long-term follow-up in patients with chronic heart failure. J Cardiovasc Electrophysiol. 2013;24:632–9.
Gurabi Z, Koncz I, Patocskai B, Nesterenko VV, Antzelevitch C. Cellular mechanism underlying hypothermia-induced VT/VF in the setting of early repolarization and the protective effect of quinidine, cilostazol and milrinone. Circ Arrhythm Electrophysiol. 2014;7:134–42.
Antzelevitch C. Genetic, molecular and cellular mechanisms underlying the J wave syndromes. Circ J. 2012;76:1054–65.
Kapplinger JD, Tester DJ, Alders M, Benito B, Berthet M, Brugada J, Brugada P, Fressart V, Guerchicoff A, Harris-Kerr C, Kamakura S, Kyndt F, Koopmann TT, Miyamoto M, Pfeiffer R, Pollevick GD, Probst V, Zumhagen S, Vatta M, Towbin JA, Shimizu W, Schulze-Bahr E, Antzelevitch C, Salisbury BA, Guicheney P, Wilde AAM, Brugada R, Schott JJ, Ackerman MJ. An international compendium of mutations in the SCN5A encoded cardiac sodium channel in patients referred for Brugada syndrome genetic testing. Heart Rhythm. 2010;7:33–46.
Burashnikov E, Pfeiffer R, Barajas-Martinez H, Delpon E, Hu D, Desai M, Borggrefe M, Haissaguerre M, Kanter R, Pollevick GD, Guerchicoff A, Laino R, Marieb M, Nademanee K, Nam GB, Robles R, Schimpf R, Stapleton DH, Viskin S, Winters S, Wolpert C, Zimmern S, Veltmann C, Antzelevitch C. Mutations in the cardiac L-type calcium channel associated J wave syndrome and sudden cardiac death. Heart Rhythm. 2010;7:1872–82.
Cordeiro JM, Marieb M, Pfeiffer R, Calloe K, Burashnikov E, Antzelevitch C. Accelerated inactivation of the L-type calcium due to a mutation in CACNB2b due to a mutation in CACNB2b underlies Brugada syndrome. J Mol Cell Cardiol. 2009;46:695–703.
Antzelevitch C, Pollevick GD, Cordeiro JM, Casis O, Sanguinetti MC, Aizawaz Y, Guerchicoff A, Pfeiffer R, Oliva A, Wollnik B, Gelber P, Bonaros Jr EP, Burashnikov E, Wu Y, Sargent JD, Schickel S, Bhatia A, Hsu LF, Haissaguerre M, Schimpf R, Borggrefe M, Wolpert C. Loss-of-function mutations in the cardiac calcium channel underline a new clinical entity characterized by ST segment elevation, short QT intervals, and sudden cardiac death. Circ Res. 2006;99:1279.
Gurnett CA, De WM, Campbell KP. Dual function of the voltage-dependent Ca2+ channel alpha 2 delta subunit in current stimulation and subunit interaction. Neuron. 1996;16:431–40.
Barajas-Martinez H, Hu D, Ferrer T, Onetti CG, Wu Y, Burashnikov E, Boyle M, Surman T, Urrutia J, Veltmann C, Schimpf R, Borggrefe M, Wolpert C, Ibrahim BB, Sanchez-Chapula JA, Winters S, Haissaguerre M, Antzelevitch C. Molecular genetic and functional association of Brugada and early repolarization syndromes with S422L missense mutation in KCNJ8. Heart Rhythm. 2012;9:548–55.
Delaney JT, Muhammad R, Blair MA, Kor K, Fish FA, Roden DM, Darbar D. A KCNJ8 mutation associated with early repolarization and atrial fibrillation. Europace. 2012;14:1428–32.
Medeiros-Domingo A, Tan BH, Crotti L, Tester DJ, Eckhardt L, Cuoretti A, Kroboth SL, Song C, Zhou Q, Kopp D, Schwartz PJ, Makielski JC, Ackerman MJ. Gain-of-function mutation S422L in the KCNJ8-encoded cardiac K(ATP) channel Kir6.1 as a pathogenic substrate for J-wave syndromes. Heart Rhythm. 2010;7:1466–71.
Hu D, Barajas-Martinez H, Medeiros-Domingo A, Crotti L, Tester DJ, Veltmann C, Schimpf R, Pfeiffer R, Dezi F, Liu Y, Burashnikov E, Giudicessi JR, Ye D, Wolpert C, Borggrefe M, Schwartz P, Ackerman MJ, Antzelevitch C. Novel mutations in the sodium channel 2 subunit gene (SCN2B) associated with Brugada syndrome and atrial fibrillation. Circulation. 2012;126:A16521.
Riuro H, Beltran-Alvarez P, Tarradas A, Selga E, Campuzano O, Verges M, Pagans S, Iglesias A, Brugada J, Brugada P, Vazquez FM, Perez GJ, Scornik FS, Brugada R. A missense mutation in the sodium channel ß2 subunit reveals SCN2B as a new candidate gene for Brugada syndrome. Hum Mutat. 2013;34:961–6.
Giudicessi JR, Ye D, Tester DJ, Crotti L, Mugione A, Nesterenko VV, Albertson RM, Antzelevitch C, Schwartz PJ, Ackerman MJ. Transient outward current (Ito) gain-of-function mutations in the KCND3-encoded Kv4.3 potassium channel and Brugada syndrome. Heart Rhythm. 2011;8:1024–32.
Delpón E, Cordeiro JM, Núñez L, Thomsen PEB, Guerchicoff A, Pollevick GD, Wu Y, Kanters JK, Larsen CT, Burashnikov A, Christiansen M, Antzelevitch C. Functional effects of KCNE3 mutation and its role in the development of Brugada syndrome. Circ Arrhythm Electrophysiol. 2008;1:209–18.
Olesen MS, Jensen NF, Holst AG, Nielsen JB, Tfelt-Hansen J, Jespersen T, Sajadieh A, Haunso S, Lund JT, Calloe K, Schmitt N, Svendsen JH. A novel nonsense variant in Nav1.5 cofactor MOG1 eliminates its sodium current increasing effect and may increase the risk of arrhythmias. Can J Cardiol. 2011;27:523.e17–23.
Kattygnarath D, Maugenre S, Neyroud N, Balse E, Ichai C, Denjoy I, Dilanian G, Martins RP, Fressart V, Berthet M, Schott JJ, Leenhardt A, Probst V, Le MH, Hainque B, Coulombe A, Hatem SN, Guicheney P. MOG1: a new susceptibility gene for Brugada syndrome. Circ Cardiovasc Genet. 2011;4:261–8.
Cerrone M, Lin X, Zhang M, Agullo-Pascual E, Pfenniger A, Chkourko GH, Novelli V, Kim C, Tirasawadischai T, Judge DP, Rothenberg E, Chen HV, Napolitano C, Priori S, Delmar M. Missense mutations in plakophilin-2 cause sodium current deficit and associate with a Brugada syndrome phenotype. Circulation. 2013;129:1092–103.
Hennessey JA, Marcou CA, Wang C, Wei EQ, Wang C, Tester DJ, Torchio M, Dagradi F, Crotti L, Schwartz PJ, Ackerman MJ, Pitt GS. FGF12 is a candidate Brugada syndrome locus. Heart Rhythm. 2013;10:1886–94.
Bezzina CR, Barc J, Mizusawa Y, Remme CA, Gourraud JB, Simonet F, Verkerk AO, Schwartz PJ, Crotti L, Dagradi F, Guicheney P, Fressart V, Leenhardt A, Antzelevitch C, Bartkowiak S, Schulze-Bahr E, Zumhagen S, Behr ER, Bastiaenen R, Tfelt-Hansen J, Olesen MS, Kaab S, Beckmann BM, Weeke P, Watanabe H, Endo N, Minamino T, Horie M, Ohno S, Hasegawa K, Makita N, Nogami A, Shimizu W, Aiba T, Froguel P, Balkau B, Lantieri O, Torchio M, Wiese C, Weber D, Wolswinkel R, Coronel R, Boukens BJ, Bezieau S, Charpentier E, Chatel S, Despres A, Gros F, Kyndt F, Lecointe S, Lindenbaum P, Portero V, Violleau J, Gessler M, Tan HL, Roden DM, Christoffels VM, Le MH, Wilde AA, Probst V, Schott JJ, Dina C, Redon R. Common variants at SCN5A-SCN10A and HEY2 are associated with Brugada syndrome, a rare disease with high risk of sudden cardiac death. Nat Genet. 2013;45:1044–9.
Boukens BJ, Sylva M, de Gier-de VC, Remme CA, Bezzina C, Christoffels VM, Coronel R. Reduced sodium channel function unmasks residual embryonic slow conduction in the adult right ventricular outflow tract. Circ Res. 2013;113:137–41.
Hartman ME, Liu Y, Zhu WZ, Chien WM, Weldy CS, Fishman GI, Laflamme MA, Chin MT. Myocardial deletion of transcription factor CHF1/Hey2 results in altered myocyte action potential and mild conduction system expansion but does not alter conduction system function or promote spontaneous arrhythmias. FASEB J. 2014;28:3007–15.
Ishikawa T, Takahashi N, Ohno S, Sakurada H, Nakamura K, On YK, Park JE, Makiyama T, Horie M, Arimura T, Makita N, Kimura A. Novel SCN3B mutation associated with Brugada syndrome affects intracellular trafficking and function of Nav1.5. Circ J. 2013;77:959–67.
Hu D, Barajas-Martinez H, Burashnikov E, Springer M, Wu Y, Varro A, Pfeiffer R, Koopmann TT, Cordeiro JM, Guerchicoff A, Pollevick GD, Antzelevitch C. A mutation in the beta 3 subunit of the cardiac sodium channel associated with Brugada ECG phenotype. Circ Cardiovasc Genet. 2009;2:270–8.
Watanabe H, Koopmann TT SLS, Yang T, Ingram CR, Schott JJ, Demolombe S, Probst V, Anselme F, Escande D, Wiesfeld AC, Pfeufer A, Kaab S, Wichmann HE, Hasdemir C, Aizawa Y, Wilde AA, Roden DM, Bezzina CR. Sodium channel b1 subunit mutations associated with Brugada syndrome and cardiac conduction disease in humans. J Clin Invest. 2008;118:2260–8.
Valdivia CR, Ueda K, Ackerman MJ, Makielski JC. GPD1L links redox state to cardiac excitability by PKC-dependent phosphorylation of the sodium channel SCN5A. Am J Physiol Heart Circ Physiol. 2009;297:H1446–52.
Shy D, Gillet L, Abriel H. Cardiac sodium channel NaV1.5 distribution in myocytes via interacting proteins: the multiple pool model. Biochim Biophys Acta. 2013;1833:886–94.
Weiss R, Barmada MM, Nguyen T, Seibel JS, Cavlovich D, Kornblit CA, Angelilli A, Villanueva F, McNamara DM, London B. Clinical and molecular heterogeneity in the Brugada syndrome: a novel gene locus on chromosome 3. Circulation. 2002;105:707–13.
Hu D, Barajas-Martinez H, Medeiros-Domingo A, Crotti L, Veltmann C, Schimpf R, Urrutia J, Alday A, Casis O, Pfeiffer R, Burashnikov E, Caceres G, Tester DJ, Wolpert C, Borggrefe M, Schwartz P, Ackerman MJ, Antzelevitch C. A novel rare variant in SCN1Bb linked to Brugada syndrome and SIDS by combined modulation of Na(v)1.5 and K(v)4.3 channel currents. Heart Rhythm. 2012;9:760–9.
Hu D, Barajas-Martinez H, Pfeiffer R, Dezi F, Pfeiffer J, Buch T, Betzenhauser MJ, Belardinelli L, Kahlig KM, Rajamani S, DeAntonio HJ, Myerburg RJ, Ito H, Deshmukh P, Marieb M, Nam GB, Bhatia A, Hasdemir C, Haissaguerre M, Veltmann C, Schimpf R, Borggrefe M, Viskin S, Antzelevitch C. Mutations in SCN10A are responsible for a large fraction of cases of Brugada syndrome. J Am Coll Cardiol. 2014;64:66–79.
Ueda K, Nakamura K, Hayashi T, Inagaki N, Takahashi M, Arimura T, Morita H, Higashiuesato Y, Hirano Y, Yasunami M, Takishita S, Yamashina A, Ohe T, Sunamori M, Hiraoka M, Kimura A. Functional characterization of a trafficking-defective HCN4 mutation, D553N, associated with cardiac arrhythmia. J Biol Chem. 2004;279:27194–8.
Reinhard W, Kaess BM, Debiec R, Nelson CP, Stark K, Tobin MD, Macfarlane PW, Tomaszewski M, Samani NJ, Hengstenberg C. Heritability of early repolarization: a population-based study. Circ Cardiovasc Genet. 2011;4:134–8.
Nunn LM, Bhar-Amato J, Lowe MD, Macfarlane PW, Rogers P, McKenna WJ, Elliott PM, Lambiase PD. Prevalence of J-point elevation in sudden arrhythmic death syndrome families. J Am Coll Cardiol. 2011;58:286–90.
Haissaguerre M, Chatel S, Sacher F, Weerasooriya R, Probst V, Loussouarn G, Horlitz M, Liersch R, Schulze-Bahr E, Wilde A, Kaab S, Koster J, Rudy Y, Le MH, Schott JJ. Ventricular fibrillation with prominent early repolarization associated with a rare variant of KCNJ8/KATP channel. J Cardiovasc Electrophysiol. 2009;20:93–8.
Watanabe H, Nogami A, Ohkubo K, Kawata H, Hayashi Y, Ishikawa T, Makiyama T, Nagao S, Yagihara N, Takehara N, Kawamura Y, Sato A, Okamura K, Hosaka Y, Sato M, Fukae S, Chinushi M, Oda H, Okabe M, Kimura A, Maemura K, Watanabe I, Kamakura S, Horie M, Aizawa Y, Shimizu W, Makita N. Electrocardiographic characteristics and SCN5A mutations in idiopathic ventricular fibrillation associated with early repolarization. Circ Arrhythm Electrophysiol. 2011;4:874–81.
Schwartz PJ, Ackerman MJ, George Jr AL, Wilde AA. Impact of genetics on the clinical management of channelopathies. J Am Coll Cardiol. 2013;62:169–80.
Le Scouarnec S, Karakachoff M, Gourraud JB, Lindenbaum P, Bonnaud S, Portero V, Duboscq-Bidot L, Daumy X, Simonet F, Teusan R, Baron E, Violleau J, Persyn E, Bellanger L, Barc J, Chatel S, Martins R, Mabo P, Sacher F, Haissaguerre M, Kyndt F, Schmitt S, Bezieau S, Le Marec H, Dina C, Schott JJ, Probst V, Redon R. Testing the burden of rare variation in arrhythmia-susceptibility genes provides new insights into molecular diagnosis for Brugada syndrome. Hum Mol Genet. 2015;24:2757–63.
Behr ER, Savio-Galimberti E, Barc J, Holst AG, Petropoulou E, Prins BP, Jabbari J, Torchio M, Berthet M, Mizusawa Y, Yang T, Nannenberg EA, Dagradi F, Weeke P, Bastiaenan R, Ackerman MJ, Haunso S, Leenhardt A, Kaab S, Probst V, Redon R, Sharma S, Wilde A, Tfelt-Hansen J, Schwartz P, Roden DM, Bezzina CR, Olesen M, Darbar D, Guicheney P, Crotti L, Jamshidi Y. Role of common and rare variants in SCN10A: results from the Brugada syndrome QRS locus gene discovery collaborative study. Cardiovasc Res. 2015;106(3):520–9.
Litovsky SH, Antzelevitch C. Transient outward current prominent in canine ventricular epicardium but not endocardium. Circ Res. 1988;62:116–26.
Antzelevitch C, Sicouri S, Litovsky SH, Lukas A, Krishnan SC, Di Diego JM, Gintant GA, Liu DW. Heterogeneity within the ventricular wall. Electrophysiology and pharmacology of epicardial, endocardial, and M cells. Circ Res. 1991;69:1427–49.
Antzelevitch C, Yan GX. Cellular and ionic mechanisms responsible for the Brugada syndrome. J Electrocardiol. 2000;33(Suppl):33–9.
Yan GX, Lankipalli RS, Burke JF, Musco S, Kowey PR. Ventricular repolarization components on the electrocardiogram: cellular basis and clinical significance. J Am Coll Cardiol. 2003;42:401–9.
Calloe K, Cordeiro JM, Di Diego JM, Hansen RS, Grunnet M, Olesen SP, Antzelevitch C. A transient outward potassium current activator recapitulates the electrocardiographic manifestations of Brugada syndrome. Cardiovasc Res. 2009;81:686–94.
Fish JM, Antzelevitch C. Role of sodium and calcium channel block in unmasking the Brugada syndrome. Heart Rhythm. 2004;1:210–7.
Koncz I, Gurabi Z, Patocskai B, Panama BK, Szel T, Hu D, Barajas-Martinez H, Antzelevitch C. Mechanisms underlying the development of the electrocardiographic and arrhythmic manifestations of early repolarization syndrome. J Mol Cell Cardiol. 2014;68C:20–8.
Shimizu W, Antzelevitch C, Suyama K, Kurita T, Taguchi A, Aihara N, Takaki H, Sunagawa K, Kamakura S. Effect of sodium channel blockers on ST segment, QRS duration, and corrected QT interval in patients with Brugada syndrome. J Cardiovasc Electrophysiol. 2000;11:1320–9.
Brugada R, Brugada J, Antzelevitch C, Kirsch GE, Potenza D, Towbin JA, Brugada P. Sodium channel blockers identify risk for sudden death in patients with ST-segment elevation and right bundle branch block but structurally normal hearts. Circulation. 2000;101:510–5.
Morita H, Morita ST, Nagase S, Banba K, Nishii N, Tani Y, Watanabe A, Nakamura K, Kusano KF, Emori T, Matsubara H, Hina K, Kita T, Ohe T. Ventricular arrhythmia induced by sodium channel blocker in patients with Brugada syndrome. J Am Coll Cardiol. 2003;42:1624–31.
Gussak I, Antzelevitch C, Bjerregaard P, Towbin JA, Chaitman BR. The Brugada syndrome: clinical, electrophysiologic and genetic aspects. J Am Coll Cardiol. 1999;33:5–15.
Krishnan SC, Antzelevitch C. Flecainide-induced arrhythmia in canine ventricular epicardium. Phase 2 reentry? Circulation. 1993;87:562–72.
Postema PG, van Dessel PFHM, Kors JA, Linnenbank AC, van Harpen G, van Eck HJ R, van Geloven N, De Bakker JMT, Wilde AAM, Tan HT. Local depolarization abnormalities are the dominant pathophysiologic mechanism for type 1 electrocardiogram in Brugada syndrome: a study of electrocardiograms, vectorcardiograms, and body surface potential maps during ajmaline provocation. J Am Coll Cardiol. 2010;55:789–97.
Nademanee K, Veerakul G, Chandanamattha P, Chaothawee L, Ariyachaipanich A, Jirasirirojanakorn K, Likittanasombat K, Bhuripanyo K, Ngarmukos T. Prevention of ventricular fibrillation episodes in Brugada syndrome by catheter ablation over the anterior right ventricular outflow tract epicardium. Circulation. 2011;123:1270–9.
Wilde AA, Postema PG, Di Diego JM, Viskin S, Morita H, Fish JM, Antzelevitch C. The pathophysiological mechanism underlying Brugada syndrome: depolarization versus repolarization. J Mol Cell Cardiol. 2010;49:543–53.
Morita H, Zipes DP, Wu J. Brugada syndrome: insights of ST elevation, arrhythmogenicity, and risk stratification from experimental observations. Heart Rhythm. 2009;6:S34–43.
Szel T, Antzelevitch C. Abnormal repolarization as the basis for late potentials and fractionated electrograms recorded from epicardium in experimental models of Brugada syndrome. J Am Coll Cardiol. 2014;63:2037–45.
Huikuri HV. Separation of benign from malignant J waves. Heart Rhythm. 2015;12:384–5.
Aizawa Y, Sato M, Kitazawa H, Aizawa Y, Takatsuki S, Oda E, Okabe M, Fukuda K. Tachycardia-dependent augmentation of “notched J waves” in a general patient population without ventricular fibrillation or cardiac arrest: not a repolarization but a depolarization abnormality? Heart Rhythm. 2015;12:376–83.
Badri M, Patel A, Yan G. Cellular and ionic basis of J-wave syndromes. Trends Cardiovasc Med. 2015;25:12–21.
Morita H, Kusano KF, Miura D, Nagase S, Nakamura K, Morita ST, Ohe T, Zipes DP, Wu J. Fragmented QRS as a marker of conduction abnormality and a predictor of prognosis of Brugada syndrome. Circulation. 2008;118:1697–704.
Priori SG, Gasparini M, Napolitano C, Della BP, Ottonelli AG, Sassone B, Giordano U, Pappone C, Mascioli G, Rossetti G, De NR, Colombo M. Risk stratification in Brugada syndrome: results of the PRELUDE (PRogrammed ELectrical stimUlation preDictive valuE) registry. J Am Coll Cardiol. 2012;59:37–45.
Terho HK, Tikkanen JT, Junttila JM, Anttonen O, Kentta TV, Aro AL, Kerola T, Rissanen HA, Reunanen A, Huikuri HV. Prevalence and prognostic significance of fragmented QRS complex in middle-aged subjects with and without clinical or electrocardiographic evidence of cardiac disease. Am J Cardiol. 2014;114:141–7.
Junttila MJ, Brugada P, Hong K, Lizotte E, de Zutter M, Sarkozy A, Brugada J, Benito B, Perkiomaki JS, Makikallio TH, Huikuri HV, Brugada R. Differences in 12-lead electrocardiogram between symptomatic and asymptomatic Brugada syndrome patients. J Cardiovasc Electrophysiol. 2008;19:380–3.
Ohkubo K, Watanabe I, Okumura Y, Ashino S, Kofune M, Nagashima K, Kofune T, Nakai T, Kunimoto S, Kasamaki Y, Hirayama A. Prolonged QRS duration in lead V2 and risk of life-threatening ventricular Arrhythmia in patients with Brugada syndrome. Int Heart J. 2011;52:98–102.
Takagi M, Aonuma K, Sekiguchi Y, Yokoyama Y, Aihara N, Hiraoka M. The prognostic value of early repolarization (J wave) and ST-segment morphology after J wave in Brugada syndrome: Multicenter study in Japan. Heart Rhythm. 2013;10:533–9.
Tokioka K, Kusano KF, Morita H, Miura D, Nishii N, Nagase S, Nakamura K, Kohno K, Ito H, Ohe T. Electrocardiographic parameters and fatal arrhythmic events in patients with Brugada syndrome: combination of depolarization and repolarization abnormalities. J Am Coll Cardiol. 2014;63:2131–8.
Kawata H, Morita H, Yamada Y, Noda T, Satomi K, Aiba T, Isobe M, Nagase S, Nakamura K, Fukushima KK, Ito H, Kamakura S, Shimizu W. Prognostic significance of early repolarization in inferolateral leads in Brugada patients with documented ventricular fibrillation: a novel risk factor for Brugada syndrome with ventricular fibrillation. Heart Rhythm. 2013;10:1161–8.
Sarkozy A, Chierchia GB, Paparella G, Boussy T, De Asmundis C, Roos M, Henkens S, Kaufman L, Buyl R, Brugada R, Brugada J, Brugada P. Inferior and lateral electrocardiographic repolarization abnormalities in Brugada syndrome. Circ Arrhythm Electrophysiol. 2009;2:154–61.
Ghosh S, Cooper DH, Vijayakumar R, Zhang J, Pollak S, Haissaguerre M, Rudy Y. Early repolarization associated with sudden death: insights from noninvasive electrocardiographic imaging. Heart Rhythm. 2010;7:534–7.
Viskin S, Adler A, Halkin A, Rosso R. Reply: is the J wave or the ST slope malignant…or neither? J Am Coll Cardiol. 2014;63:1812–3.
Brugada J, Brugada R, Brugada P. Pharmacological and device approach to therapy of inherited cardiac diseases associated with cardiac arrhythmias and sudden death. J Electrocardiol. 2000;33(Suppl):41–7.
Brugada P, Brugada R, Brugada J, Geelen P. Use of the prophylactic implantable cardioverter defibrillator for patients with normal hearts. Am J Cardiol. 1999;83:98D–100.
Priori SG, Wilde AA, Horie M, Cho Y, Behr ER, Berul C, Blom N, Brugada J, Chiang CE, Huikuri H, Kannankeril P, Krahn A, Leenhardt A, Moss A, Schwartz PJ, Shimizu W, Tomaselli G, Tracy C. Executive summary: HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes. Heart Rhythm. 2013;15:1389–406.
De Maria E, Bonetti L, Patrizi G, Scrivener J, Andraghetti A, Di GF, Montin A, Zuccon G, Cappelli S. Implantation of a completely subcutaneous ICD system: case report of a patient with Brugada syndrome and state of the art. J Interv Card Electrophysiol. 2012;34:105–13.
Griksaitis MJ, Rosengarten JA, Gnanapragasam JP, Haw MP, Morgan JM. Implantable cardioverter defibrillator therapy in paediatric practice: a single-centre UK experience with focus on subcutaneous defibrillation. Europace. 2013;15:523–30.
Rowley CP, Lobodzinski SS, Gold MR. The subcutaneous defibrillator. Curr Treat Options Cardiovasc Med. 2012;14:550–7.
Bardy GH, Smith WM, Hood MA, Crozier IG, Melton IC, Jordaens L, Theuns D, Park RE, Wright DJ, Connelly DT, Fynn SP, Murgatroyd FD, Sperzel J, Neuzner J, Spitzer SG, Ardashev AV, Oduro A, Boersma L, Maass AH, Van Gelder IC, Wilde AA, van Dessel PF, Knops RE, Barr CS, Lupo P, Cappato R, Grace AA. An entirely subcutaneous implantable cardioverter-defibrillator. N Engl J Med. 2010;363:36–44.
van Den Berg MP, Wilde AA, Viersma TJW, Brouwer J, Haaksma J, van der Hout AH, Stolte-Dijkstra I, Bezzina TCR, Van Langen IM, Beaufort-Krol GC, Cornel JH, Crijns HJ. Possible bradycardic mode of death and successful pacemaker treatment in a large family with features of long QT syndrome type 3 and Brugada syndrome. J Cardiovasc Electrophysiol. 2001;12:630–6.
Bertomeu-Gonzalez V, Ruiz-Granell R, Garcia-Civera R, Morell-Cabedo S, Ferrero A. Syncopal monomorphic ventricular tachycardia with pleomorphism, sensitive to antitachycardia pacing in a patient with Brugada syndrome. Europace. 2006;8:1048–50.
Lee KL, Lau C, Tse H, Wan S, Fan K. Prevention of ventricular fibrillation by pacing in a man with Brugada syndrome. J Cardiovasc Electrophysiol. 2000;11:935–7.
Haissaguerre M, Extramiana F, Hocini M, Cauchemez B, Jais P, Cabrera JA, Farre G, Leenhardt A, Sanders P, Scavee C, Hsu LF, Weerasooriya R, Shah DC, Frank R, Maury P, Delay M, Garrigue S, Clementy J. Mapping and ablation of ventricular fibrillation associated with long-QT and Brugada syndromes. Circulation. 2003;108:925–8.
Cortez-Dias N, Placido R, Marta L, Bernardes A, Sobral S, Carpinteiro L, de Sousa J. Epicardial ablation for prevention of ventricular fibrillation in a patient with Brugada syndrome. Rev Port Cardiol. 2014;33:305.e1–7.
Brugada J, Brugada R, Brugada P. Right bundle-branch block and ST-segment elevation in leads V1 through V3. A marker for sudden death in patients without demonstrable structural heart disease. Circulation. 1998;97:457–60.
Chinushi M, Aizawa Y, Ogawa Y, Shiba M, Takahashi K. Discrepant drug action of disopyramide on ECG abnormalities and induction of ventricular arrhythmias in a patient with Brugada syndrome. J Electrocardiol. 1997;30:133–6.
Antzelevitch C, Brugada P, Brugada J, Brugada R, Nademanee K, Towbin JA. Clinical approaches to tachyarrhythmias. The Brugada syndrome. Armonk: Futura Publishing Company; 1999.
Minoura Y, Di Diego JM, Barajas-Martinez H, Zygmunt AC, Hu D, Sicouri S, Antzelevitch C. Ionic and cellular mechanisms underlying the development of acquired Brugada syndrome in patients treated with antidepressants. J Cardiovasc Electrophysiol. 2012;23:423–32.
Minoura Y, Panama BK, Nesterenko VV, Betzenhauser M, Barajas-Martinez H, Hu D, Di Diego JM, Antzelevitch C. Effect of Wenxin Keli and quinidine to suppress arrhythmogenesis in an experimental model of Brugada syndrome. Heart Rhythm. 2013;10:1054–62.
Alings M, Dekker L, Sadee A, Wilde A. Quinidine induced electrocardiographic normalization in two patients with Brugada syndrome. Pacing Clin Electrophysiol. 2001;24:1420–2.
Belhassen B, Viskin S, Antzelevitch C. The Brugada syndrome: is an implantable cardioverter defibrillator the only therapeutic option? Pacing Clin Electrophysiol. 2002;25:1634–40.
Belhassen B, Viskin S. Pharmacologic approach to therapy of Brugada syndrome: quinidine as an alternative to ICD therapy? In: Antzelevitch C, Brugada P, Brugada J, Brugada R, editors. The Brugada syndrome: from bench to bedside. Oxford: Blackwell Futura; 2004. p. 202–11.
Viskin S, Wilde AA, Tan HL, Antzelevitch C, Shimizu W, Belhassen B. Empiric quinidine therapy for asymptomatic Brugada syndrome: time for a prospective registry. Heart Rhythm. 2009;6:401–4.
Belhassen B, Glick A, Viskin S. Excellent long-term reproducibility of the electrophysiologic efficacy of quinidine in patients with idiopathic ventricular fibrillation and Brugada syndrome. Pacing Clin Electrophysiol. 2009;32:294–301.
Marquez MF, Bonny A, Hernandez-Castillo E, De SA, Gomez-Flores J, Nava S, Hidden-Lucet F, Iturralde P, Cardenas M, Tonet J. Long-term efficacy of low doses of quinidine on malignant arrhythmias in Brugada syndrome with an implantable cardioverter-defibrillator: a case series and literature review. Heart Rhythm. 2013;9:1995–2000.
Pellegrino PL, Di BM, Brunetti ND. Quinidine for the management of electrical storm in an old patient with Brugada syndrome and syncope. Acta Cardiol. 2013;68:201–3.
Probst V, Evain S, Gournay V, Marie A, Schott JJ, Boisseau P, Le MH. Monomorphic ventricular tachycardia due to Brugada syndrome successfully treated by hydroquinidine therapy in a 3-year-old child. J Cardiovasc Electrophysiol. 2006;17:97–100.
Schweizer PA, Becker R, Katus HA, Thomas D. Successful acute and long-term management of electrical storm in Brugada syndrome using orciprenaline and quinine/quinidine. Clin Res Cardiol. 2010;99:467–70.
Hasegawa K, Ashihara T, Kimura H, Jo H, Itoh H, Yamamoto T, Aizawa Y, Horie M. Long-term pharmacological therapy of Brugada syndrome: is J-wave attenuation a marker of drug efficacy? Intern Med. 2014;53:1523–6.
Marquez MF, Rivera J, Hermosillo AG, Iturralde P, Colin L, Moragrega JL, Cardenas M. Arrhythmic storm responsive to quinidine in a patient with Brugada syndrome and vasovagal syncope. Pacing Clin Electrophysiol. 2005;28:870–3.
Viskin S, Antzelevitch C, Marquez MF, Belhassen B. Quinidine: a valuable medication joins the list of ‘endangered species’. Europace. 2007;12:1105–6.
Ohgo T, Okamura H, Noda T, Satomi K, Suyama K, Kurita T, Aihara N, Kamakura S, Ohe T, Shimizu W. Acute and chronic management in patients with Brugada syndrome associated with electrical storm of ventricular fibrillation. Heart Rhythm. 2007;4:695–700.
Rosso R, Glick A, Glikson M, Wagshal A, Swissa M, Rosenhek S, Shetboun I, Khalamizer V, Fuchs T, Boulos M, Geist M, Strasberg B, Ilan M, Belhassen B. Outcome after implantation of cardioverter defribrillator in patients with Brugada syndrome: a multicenter Israeli study (ISRABRU). Israel Med Assoc J. 2008;10:435–9.
Belhassen B, Viskin S, Fish R, Glick A, Setbon I, Eldar M. Effects of electrophysiologic-guided therapy with Class IA antiarrhythmic drugs on the long-term outcome of patients with idiopathic ventricular fibrillation with or without the Brugada syndrome. J Cardiovasc Electrophysiol. 1999;10:1301–12.
Hermida JS, Denjoy I, Clerc J, Extramiana F, Jarry G, Milliez P, Guicheney P, Di Fusco S, Rey JL, Cauchemez B, Leenhardt A. Hydroquinidine therapy in Brugada syndrome. J Am Coll Cardiol. 2004;43:1853–60.
Mok NS, Chan NY, Chi-Suen CA. Successful use of quinidine in treatment of electrical storm in Brugada syndrome. Pacing Clin Electrophysiol. 2004;27:821–3.
Viskin S. Empiric quinidine for asymptomatic Brugada syndrome. International Registry of Asymptomatic Brugada Syndrome. 2008. http://clinicaltrials.gov/ct2/show/NCT00789165?term_brugada&rank_2.
Sanofi. Hydroquinidine versus placebo in patients with Brugada syndrome (Quidam). 24 June 2009. https://clinicaltrials.gov/ct2/show/study/NCT00927732. Trial Terminated.
Fish JM, Extramiana F, Antzelevitch C. Tedisamil abolishes the arrhythmogenic substrate responsible for VT/VF in an experimental model of the Brugada syndrome. Heart Rhythm. 2004;1(1S):S158.
Antzelevitch C, Shimizu W, Yan GX, Sicouri S, Weissenburger J, Nesterenko VV, Burashnikov A, Di Diego JM, Saffitz J, Thomas GP. The M cell: its contribution to the ECG and to normal and abnormal electrical function of the heart. J Cardiovasc Electrophysiol. 1999;10:1124–52.
Antzelevitch C, Shimizu W. Cellular mechanisms underlying the long QT syndrome. Curr Opin Cardiol. 2002;17:43–51.
Belardinelli L, Antzelevitch C, Vos MA. Assessing predictors of drug-induced torsade de pointes. Trends Pharmacol Sci. 2003;24:619–25.
Fish JM, Extramiana F, Antzelevitch C. AVE0118, an Ito and IKur blocker, suppresses VT/VF in an experimental model of the Brugada syndrome. Circulation. 2004;110(17):III–193.
Antzelevitch C. The Brugada syndrome: ionic basis and arrhythmia mechanisms. J Cardiovasc Electrophysiol. 2001;12:268–72.
Tsuchiya T, Ashikaga K, Honda T, Arita M. Prevention of ventricular fibrillation by cilostazol, an oral phosphodiesterase inhibitor, in a patient with Brugada syndrome. J Cardiovasc Electrophysiol. 2002;13:698–701.
Kyriazis K, Bahlmann E, van der Schalk H, Kuck KH. Electrical storm in Brugada syndrome successfully treated with orciprenaline; effect of low-dose quinidine on the electrocardiogram. Europace. 2009;11:665–6.
Maury P, Couderc P, Delay M, Boveda S, Brugada J. Electrical storm in Brugada syndrome successfully treated using isoprenaline. Europace. 2004;6:130–3.
Maury P, Hocini M, Haissaguerre M. Electrical storms in Brugada syndrome: review of pharmacologic and ablative therapeutic options. Indian Pacing Electrophysiol J. 2005;5:25–34.
Jongman JK, Jepkes-Bruin N, Ramdat Misier AR, Beukema WP, Delnoy PP, Oude LH, Dambrink JH, Hoorntje JC, Elvan A. Electrical storms in Brugada syndrome successfully treated with isoproterenol infusion and quinidine orally. Neth Heart J. 2007;15:151–5.
Watanabe A, Fukushima KK, Morita H, Miura D, Sumida W, Hiramatsu S, Banba K, Nishii N, Nagase S, Nakamura K, Sakuragi S, Ohe T. Low-dose isoproterenol for repetitive ventricular arrhythmia in patients with Brugada syndrome. Eur Heart J. 2006;27:1579–83.
Furniss G. Isoprenaline and quinidine to calm Brugada VF storm. BMJ Case Rep. 2012. pii: bcr0420114156. doi:10.1136/bcr.04.2011.4156.
Shimizu W, Matsuo K, Takagi M, Tanabe Y, Aiba T, Taguchi A, Suyama K, Kurita T, Aihara N, Kamakura S. Body surface distribution and response to drugs of ST segment elevation in Brugada syndrome: clinical implication of eighty-seven-lead body surface potential mapping and its application to twelve-lead electrocardiograms. J Cardiovasc Electrophysiol. 2000;11:396–404.
Suzuki H, Torigoe K, Numata O, Yazaki S. Infant case with a malignant form of Brugada syndrome. J Cardiovasc Electrophysiol. 2000;11:1277–80.
Tanaka H, Kinoshita O, Uchikawa S, Kasai H, Nakamura M, Izawa A, Yokoseki O, Kitabayashi H, Takahashi W, Yazaki Y, Watanabe N, Imamura H, Kubo K. Successful prevention of recurrent ventricular fibrillation by intravenous isoproterenol in a patient with Brugada syndrome. Pacing Clin Electrophysiol. 2001;24:1293–4.
Miyazaki T, Mitamura H, Miyoshi S, Soejima K, Aizawa Y, Ogawa S. Autonomic and antiarrhythmic drug modulation of ST segment elevation in patients with Brugada syndrome. J Am Coll Cardiol. 1996;27:1061–70.
Shimizu W, Kamakura S. Catecholamines in children with congenital long QT syndrome and Brugada syndrome. J Electrocardiol. 2001;34(Suppl):173–5.
Sharif-Kazemi MB, Emkanjoo Z, Tavoosi A, Kafi M, Kheirkhah J, Alizadeh A, Sadr-Ameli MA. Electrical storm in Brugada syndrome during pregnancy. Pacing Clin Electrophysiol. 2011;34:e18–21.
Roten L, Derval N, Sacher F, Pascale P, Scherr D, Komatsu Y, Ramoul K, Daly M, Denis A, Shah AJ, Hocini M, Jais P, Haissaguerre M. Heterogeneous response of J wave syndromes to beta-adrenergic stimulation. Heart Rhythm. 2012;9:1970–6.
Kaneko Y, Horie M, Niwano S, Kusano K, Takatsuki S, Kurita T, Mitsuhashi T, Nakajima T, Irie T, Hasegawa K, Noda T, Kamakura S, Aizawa Y, Yasuoka R, Torigoe K, Suzuki H, Ohe T, Shimizu A, Fukuda K, Kurabayashi M, Aizawa Y. Electrical storm in patients with Brugada syndrome is associated with early repolarization. Circ Arrhythm Electrophysiol. 2014;7:1122–8.
Agac MT, Erkan H and Korkmaz L. Conversion of Brugada type I to type III and successful control of recurrent ventricular arrhythmia with cilostazol. Arch Cardiovasc Dis. 2014;107(8–9):476–8.
Kanlop N, Chattipakorn S, Chattipakorn N. Effects of cilostazol in the heart. J Cardiovasc Med (Hangerstown). 2011;12:88–95.
Bai Y, Muqier, Murakami H, Iwasa M, Sumi S, Yamada Y, Ushikoshi H, Aoyama T, Nishigaki K, Takemura G, Uno B, Minatoguchi S. Cilostazol protects the heart against ischaemia reperfusion injury in a rabbit model of myocardial infarction: focus on adenosine, nitric oxide and mitochondrial ATP-sensitive potassium channels. Clin Exp Pharmacol Physiol. 2011;38:658–65.
Shinohara T, Ebata Y, Ayabe R, Fukui A, Okada N, Yufu K, Nakagawa M, Takahashi N. Combination therapy of cilostazol and bepridil suppresses recurrent ventricular fibrillation related to J-wave syndromes. Heart Rhythm. 2014;11:1441–5.
Abud A, Bagattin D, Goyeneche R, Becker C. Failure of cilostazol in the prevention of ventricular fibrillation in a patient with Brugada syndrome. J Cardiovasc Electrophysiol. 2006;17:210–2.
Szel T, Koncz I, Antzelevitch C. Cellular mechanisms underlying the effects of milrinone and cilostazol to suppress arrhythmogenesis associated with Brugada syndrome. Heart Rhythm. 2013;10:1720–7.
Sugao M, Fujiki A, Nishida K, Sakabe M, Tsuneda T, Iwamoto J, Mizumaki K, Inoue H. Repolarization dynamics in patients with idiopathic ventricular fibrillation: pharmacological therapy with bepridil and disopyramide. J Cardiovasc Pharmacol. 2005;45:545–9.
Murakami M, Nakamura K, Kusano KF, Morita H, Nakagawa K, Tanaka M, Tada T, Toh N, Nishii N, Nagase S, Hata Y, Kohno K, Miura D, Ohe T, Ito H. Efficacy of low-dose bepridil for prevention of ventricular fibrillation in patients with Brugada syndrome with and without SCN5A mutation. J Cardiovasc Pharmacol. 2010;56:389–95.
Aizawa Y, Yamakawa H, Takatsuki S, Katsumata Y, Nishiyama T, Kimura T, Nishiyama N, Fukumoto K, Tanimoto Y, Tanimoto K, Mitamura H, Ogawa S, Fukuda K. Efficacy and safety of bepridil for prevention of ICD shocks in patients with Brugada syndrome and idiopathic ventricular fibrillation. Int J Cardiol. 2013;168:5083–5.
Kang L, Zheng MQ, Morishima M, Wang Y, Kaku T, Ono K. Bepridil up-regulates cardiac Na+ channels as a long-term effect by blunting proteasome signals through inhibition of calmodulin activity. Br J Pharmacol. 2009;157:404–14.
Tamura A, Ogura T, Uemura H, Reien Y, Kishimoto T, Nagai T, Komuro I, Miyazaki M, Nakaya H. Effects of antiarrhythmic drugs on the hyperpolarization-activated cyclic nucleotide-gated channel current. J Pharm Sci. 2009;110:150–9.
Burashnikov A, Petroski A, Hu D, Barajas-Martinez H, Antzelevitch C. Atrial-selective inhibition of sodium channel current by Wenxin Keli is effective in suppressing atrial fibrillation. Heart Rhythm. 2012;9:125–31.
Wang X, Wang X, Gu Y, Wang T, Huang C. Wenxin Keli attenuates ischemia-induced ventricular arrhythmias in rats: involvement of Ltype calcium and transient outward potassium currents. Mol Med Rep. 2013;7:519–24.
Fish JM, Welchons DR, Kim YS, Lee SH, Ho WK, Antzelevitch C. Dimethyl lithospermate B, an extract of Danshen, suppresses arrhythmogenesis associated with the Brugada syndrome. Circulation. 2006;113:1393–400.
Aizawa Y, Chinushi M, Hasegawa K, Naiki N, Horie M, Kaneko Y, Kurabayashi M, Ito S, Imaizumi T, Aizawa Y, Takatsuki S, Joo K, Sato M, Ebe K, Hosaka Y, Haissaguerre M, Fukuda K. Electrical storm in idiopathic ventricular fibrillation is associated with early repolarization. J Am Coll Cardiol. 2013;62:1015–9.
Haissaguerre M, Sacher F, Nogami A, Komiya N, Bernard A, Probst V, Yli-Mayry S, Defaye P, Aizawa Y, Frank R, Mantovan R, Cappato R, Wolpert C, Leenhardt A, De Roy L, Heidbuchel H, Deisenhofer I, Arentz T, Pasquie JL, Weerasooriya R, Hocini M, Jais P, Derval N, Bordachar P, Clementy J. Characteristics of recurrent ventricular fibrillation associated with inferolateral early repolarization role of drug therapy. J Am Coll Cardiol. 2009;53:612–9.
Sacher F, Derval N, Horlitz M, Haissaguerre M. J wave elevation to monitor quinidine efficacy in early repolarization syndrome. J Electrocardiol. 2014;47:223–5.
Iguchi K, Noda T, Kamakura S, Shimizu W. Beneficial effects of cilostazol in a patient with recurrent ventricular fibrillation associated with early repolarization syndrome. Heart Rhythm. 2013;10:604–6.
Kanlop N, Shinlapawittayatorn K, Sungnoon R, Weerateerangkul P, Chattipakorn S, Chattipakorn N. Cilostazol attenuates ventricular arrhythmia induction and improves defibrillation efficacy in swine. Can J Physiol Pharmacol. 2010;88:422–8.
Endoh M, Yanagisawa T, Taira N, Blinks JR. Effects of new inotropic agents on cyclic nucleotide metabolism and calcium transients in canine ventricular muscle. Circulation. 1986;73:III117–33.
Rapundalo ST, Grupp I, Grupp G, Abdul MM, Solaro RJ, Schwartz A. Myocardial actions of milrinone: characterization of its mechanism of action. Circulation. 1986;73:III134–44.
Atarashi H, Endoh Y, Saitoh H, Kishida H, Hayakawa H. Chronotropic effects of cilostazol, a new antithrombotic agent, in patients with bradyarrhythmias. J Cardiovasc Pharmacol. 1998;31:534–9.
Matsui K, Kiyosue T, Wang JC, Dohi K, Arita M. Effects of pimobendan on the L-type Ca2+ current and developed tension in guinea-pig ventricular myocytes and papillary muscle: comparison with IBMX, milrinone, and cilostazol. Cardiovasc Drugs Ther. 1999;13:105–13.
Antzelevitch C, Yan GX, Viskin S. Rationale for the use of the terms J-wave syndromes and early repolarization. J Am Coll Cardiol. 2011;57:1587–90.
Patocskai B, Antzelevitch C. Novel therapeutic strategies for the management of ventricular arrhythmias associated with the Brugada syndrome. Expert Opin Orphan Drugs. 2015;3(6):633–51.
Antzelevitch C, Brugada P, Borggrefe M, Brugada J, Brugada R, Corrado D, Gussak I, LeMarec H, Nademanee K, Perez Riera AR, Shimizu W, Schulze-Bahr E, Tan H, Wilde A. Brugada syndrome: report of the second consensus conference. Heart Rhythm. 2005;2:429–40.
Watanabe H, Makiyama T, Koyama T, Kannankeril PJ, Seto S, Okamura K, Oda H, Itoh H, Okada M, Tanabe N, Yagihara N, Kamakura S, Horie M, Aizawa Y, Shimizu W. High prevalence of early repolarization in short QT syndrome. Heart Rhythm. 2010;7:647–52.
Gang ES, Priori SS, Chen PS. Short coupled premature ventricular contraction initiating ventricular fibrillation in a patient with Brugada syndrome. J Cardiovasc Electrophysiol. 2004;15:837.
Qi X, Sun F, An X, Yang J. A case of Brugada syndrome with ST segment elevation through entire precordial leads. Chin J Cardiol. 2004;32:272–3.
Priori SG, Napolitano C, Gasparini M, Pappone C, Della BP, Giordano U, Bloise R, Giustetto C, De Nardis R, Grillo M, Ronchetti E, Faggiano G, Nastoli J. Natural history of Brugada syndrome: insights for risk stratification and management. Circulation. 2002;105:1342–7.
Probst V, Veltmann C, Eckardt L, Meregalli PG, Gaita F, Tan HL, Babuty D, Sacher F, Giustetto C, Schulze-Bahr E, Borggrefe M, Haissaguerre M, Mabo P, Le Marec H, Wolpert C, Wilde AAM. Long-term prognosis of patients diagnosed with Brugada syndrome: results from the FINGER Brugada Syndrome Registry. Circulation. 2010;121:635–43.
Delise P, Allocca G, Marras E, Giustetto C, Gaita F, Sciarra L, Calo L, Proclemer A, Marziali M, Rebellato L, Berton G, Coro L, Sitta N. Risk stratification in individuals with the Brugada type 1 ECG pattern without previous cardiac arrest: usefulness of a combined clinical and electrophysiologic approach. Eur Heart J. 2011;32:169–76.
Ikeda T, Sakurada H, Sakabe K, Sakata T, Takami M, Tezuka N, Nakae T, Noro M, Enjoji Y, Tejima T, Sugi K, Yamaguchi T. Assessment of noninvasive markers in identifying patients at risk in the Brugada syndrome: insight into risk stratification. J Am Coll Cardiol. 2001;37:1628–34.
Yoshioka K, Amino M, Zareba W, Shima M, Matsuzaki A, Fujii T, Kanda S, Deguchi Y, Kobayashi Y, Ikari Y, Kodama I, Tanabe T. Identification of high-risk Brugada syndrome patients by combined analysis of late potential and T-wave amplitude variability on ambulatory electrocardiograms. Circ J. 2013;77:610–8.
Aizawa Y, Chinushi M, Tagawa M, Furushima H, Okada S, Iijima K, Izumi D, Watanabe H, Komura S. A post-QRS potential in Brugada syndrome: its relation to electrocardiographic pattern and possible genesis. J Am Coll Cardiol. 2008;51:1720–1.
Furushima H, Chinushi M, Okamura K, Iijima K, Komura S, Tanabe Y, Okada S, Izumi D, Aizawa Y. Comparison of conduction delay in the right ventricular outflow tract between Brugada syndrome and right ventricular cardiomyopathy: investigation of signal average ECG in the precordial leads. Europace. 2007;9:951–6.
Nagase S, Kusano KF, Morita H, Fujimoto Y, Kakishita M, Nakamura K, Emori T, Matsubara H, Ohe T. Epicardial electrogram of the right ventricular outflow tract in patients with the Brugada syndrome: using the epicardial lead. J Am Coll Cardiol. 2002;39:1992–5.
Huang Z, Patel C, Li W, Xie Q, Wu R, Zhang L, Tang R, Wan X, Ma Y, Zhen W, Gao L, Yan GX. Role of signal-averaged electrocardiograms in arrhythmic risk stratification of patients with Brugada syndrome: a prospective study. Heart Rhythm. 2009;6:1156–62.
Castro Hevia J, Antzelevitch C, Tornés Bárzaga F, Dorantes Sánchez M, Dorticós Balea F, Zayas Molina R, Quiñones Pérez MA, Fayad RY. Tpeak-Tend and Tpeak-Tend dispersion as risk factors for ventricular tachycardia/ventricular fibrillation in patients with the Brugada syndrome. J Am Coll Cardiol. 2006;47:1828–34.
Letsas KP, Weber R, Astheimer K, Kalusche D, Arentz T. Tpeak-Tend interval and Tpeak-Tend/QT ratio as markers of ventricular tachycardia inducibility in subjects with Brugada ECG phenotype. Europace. 2010;12:271–4.
Karim Talib A, Sato N, Sakamoto N, Tanabe Y, Takeuchi T, Saijo Y, Kawamura Y, Hasebe N. Enhanced transmural dispersion of repolarization in patients with J wave syndromes. J Cardiovasc Electrophysiol. 2012;23:1109–14.
Lambiase PD. Tpeak-Tend interval and Tpeak-Tend/QT ratio as markers of ventricular tachycardia inducibility in subjects with Brugada ECG phenotype. Europace. 2010;12:158–9.
Uzieblo-Zyczkowska B, Gielerak G, Michalkiewicz D. Usefulness of patient’s history and non-invasive electrocardiographic parameters in prediction of ajmaline test results in patients with suspected Brugada syndrome. Arch Med Sci: AMS. 2014;10:899–912.
Wang JF, Shan QJ, Yang B, Chen ML, Zou JG, Chen C, Xu DJ, Cao KJ. Tpeak-Tend interval and risk of cardiac events in patients with Brugada syndrome. Zhonghua Xin Xue Guan Bing Za Zhi. 2007;35:629–32.
Talib AK, Sato N, Kawabata N, Sugiyama E, Sakamoto N, Tanabe Y, Fujino T, Takeuchi T, Saijo Y, Akasaka K, Kawamura Y, Hasebe N. Repolarization characteristics in early repolarization and Brugada syndromes: insight into an overlapping mechanism of lethal arrhythmias. J Cardiovasc Electrophysiol. 2014;25:1376–84.
Makimoto H, Nakagawa E, Takaki H, Yamada Y, Okamura H, Noda T, Satomi K, Suyama K, Aihara N, Kurita T, Kamakura S, Shimizu W. Augmented ST-segment elevation during recovery from exercise predicts cardiac events in patients with Brugada syndrome. J Am Coll Cardiol. 2010;56:1576–84.
Tatsumi H, Takagi M, Nakagawa E, Yamashita H, Yoshiyama M. Risk stratification in patients with Brugada syndrome: analysis of daily fluctuations in 12-lead electrocardiogram (ECG) and signal-averaged electrocardiogram (SAECG). J Cardiovasc Electrophysiol. 2006;17:705–11.
Nakagawa E, Takagi M, Tatsumi H, Yoshiyama M. Successful radiofrequency catheter ablation for electrical storm of ventricular fibrillation in a patient with Brugada syndrome. Circ J. 2008;72:1025–9.
Shah AJ, Hocini M, Lamaison D, Sacher F, Derval N, Haissaguerre M. Regional substrate ablation abolishes Brugada syndrome. J Cardiovasc Electrophysiol. 2011;22:1290–1.
Sunsaneewitayakul B, Yao Y, Thamaree S, Zhang S. Endocardial mapping and catheter ablation for ventricular fibrillation prevention in Brugada syndrome. J Cardiovasc Electrophysiol. 2012;23 Suppl 1:S10–6.
Matana A, Goldner V, Stanic K, Mavric Z, Zaputovic L, Matana Z. Unmasking effect of propafenone on the concealed form of the Brugada phenomenon. Pacing Clin Electrophysiol. 2000;23:416–8.
Antzelevitch C, Yan GX. J wave syndromes. Mechanisms, diagnosis, prognosis, risk stratification and treatment of Brugada and early repolarization syndromes. Heart Rhythm. 2015;12(8):1852–66.
Funding
This study was supported by grant HL47678 from the NHLBI (CA) I. Wistar and Martha Morris (CA), and by the Sharpe-Strumia Research Foundation (GXY), and grant NSFC-81370289 from National Natural Science Foundation of China (GXY).
Disclosures
Dr. Antzelevitch was a consultant for Gilead Sciences and received funding from Gilead Sciences and Buchang Pharmaceuticals.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Antzelevitch, C., Patocskai, B. (2016). Ionic and Cellular Mechanisms Underlying J Wave Syndromes. In: Antzelevitch, C., Yan, GX. (eds) J Wave Syndromes. Springer, Cham. https://doi.org/10.1007/978-3-319-31578-2_3
Download citation
DOI: https://doi.org/10.1007/978-3-319-31578-2_3
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-31576-8
Online ISBN: 978-3-319-31578-2
eBook Packages: MedicineMedicine (R0)