Electrocardiographic "Northwest QRS Axis" in the Brugada Syndrome: A Potential Marker to Predict Poor Outcome

Andrés Ricardo Pérez-Riera; Frank Yanowitz; Raimundo Barbosa-Barros; Rodrigo Daminello-Raimundo; Luiz Carlos de Abreu; Kjell Nikus; Pedro Brugada

doi:10.1016/j.jaccas.2020.07.037

Electrocardiographic "Northwest QRS Axis" in the Brugada Syndrome: A Potential Marker to Predict Poor Outcome

JACC Case Rep. 2020 Oct 7;2(14):2230-2234. doi: 10.1016/j.jaccas.2020.07.037. eCollection 2020 Nov 18.

Authors

Andrés Ricardo Pérez-Riera¹, Frank Yanowitz², Raimundo Barbosa-Barros³, Rodrigo Daminello-Raimundo¹, Luiz Carlos de Abreu^{1

4}, Kjell Nikus⁵, Pedro Brugada⁶

Affiliations

¹ Laboratório de Metodologia de Pesquisa e Escrita Científica, Centro Universitário Saúde ABC, Santo André, São Paulo, Brazil.
² Intermountain Medical Center, Intermountain Heart Institute, Department of Internal Medicine, The University of Utah, Salt Lake City, Utah.
³ Coronary Center of the Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza, Ceará, Brazil.
⁴ Graduate Entry Medical School, University of Limerick, Limerick, Ireland.
⁵ Heart Center, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
⁶ Cardiovascular Division, Free University of Brussels (UZ Brussel) VUB, Brussels, Belgium.

Abstract

Conduction delay in the right ventricular outflow tract as manifested in the electrocardiogram constitutes a high-risk predictor of ventricular arrhythmias in patients with Brugada syndrome. We present a case with a right QRS axis between -90° and ±180°. This feature has never been reported in the context of Brugada syndrome. (Level of Difficulty: Advanced.).

Keywords: AF, atrial fibrillation; BrS, Brugada syndrome; ECG, electrocardiogram; EPS, electrophysiological study; ICD, implantable cardioverter defibrillator; RVOT, right ventricular outflow tract; SCD, sudden cardiac death; SSS, sick sinus syndrome; VF, ventricular fibrillation; VTA, ventricular tachyarrhythmia; peripheral right blocks; right distal blockages; terminal conduction delay; zonal right blocks; zonal right conduction defect.

Publication types

Case Reports