Brugada or Early Repolarization in V1 V2 V3. Can VCG Aspects Differentiate the Localization of ECG Manifestations ?

Electrocardiographic aspects in Brugada syndrome (BrS) and early repolarization (ER) may confuse the diagnosis, especially when located in the anteroseptal region of the rest-ECG (V1-V3). Vectorcardiography (VCG) is useful to differentiate the two situations, both through visual characteristics of vector loops and quantification of certain measurements. The objective of this study was to define BrS and ER characteristic and distinctive patterns, using aspects of QRS complex loops and ST segments. SÂJ-point of vectorcardiographic loops in the horizontal plane (HP) of 29 BrS patients and 30 individuals with ER were analyzed. J-point resulting vector was obtained by the noncoincidence between QRS complex onset and end. We measured and compared the angle of this resulting vector in PH between groups. Non-paired t-test and ROC curve were used, with P ≤ 0.05. Men age was 47 ± 15 vs 38 ± 14 y.o. (p = 0.02), 66% vs 90% male (p = 0.03); QRS duration was 101.6 ± 10.2 vs 94.9 ± 12.5ms (p = 0.03); mean SÂJ-point was 103.4o ± 18.9o vs 54.5o ± 16.3o (p < 0.0001), BrS vs ERS, respectively. SÂJ-point > 75o cut-off value as obtained by ROC curve better identified BrS, with 96.6 % sensitivity and 93.3 % specificity. SÂJ-point >75°, as assessed by vectorcardiography can differentiate between the Brugada syndrome and early repolarization with high sensitivity and specificity.