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European Heart Journal 2003 24(19):1771-1778; doi:10.1016/j.ehj.2003.06.005
Copyright © 2003 by the European Society of Cardiology.
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Clinical research

Heart rate variability in patients with Brugada syndrome in Thailand

Rungroj Krittayaphonga,*, Gumpanart Veerakulb, Koonlawee Nademaneec and Charuwan Kangkagated

a Division of Cardiology, Department of Medicine. Siriraj Hospital, Mahidol University, Bangkok, Thailand
b Division of Cardiology, Department of Medicine, Bhumipol Adulyadej Hospital, Bangkok, Thailand
c Pacific Rim Electrophysiology Research Institute, Inglewood, CA, USA
d Department of Research Promotion, Siriraj Hospital, Mahidol University, Bangkok, Thailand

* Correspondence to: Rungroj Krittayaphong, MD, Division of Cardiology, Department of Medicine, Siriraj Hospital, Bangkoknoi, Bangkok 10700, Thailand. Tel: +662 419-8813 ext 6093; Fax: +662 2-7412
E-mail address: sirkt{at}mahidol.ac.th

Received 27 April 2003; revised 30 May 2003; accepted 19 June 2003

Abstract

Aims Since patients with Brugada syndrome usually have symptoms at nighttime, we hypothesize that changes in autonomic modulation have an important role in the occurrence of the ventricular fibrillation episodes. The objective of this study was to determine the changes in heart rate variability (HRV) in patients with Brugada syndrome compared to asymptomatic subjects with Brugada ECG and controls.

Methods and results We studied 17 patients with Brugada syndrome, 10 asymptomatic subjects with Brugada ECG and 45 controls. Patients with Brugada syndrome and asymptomatic subjects with Brugada ECG underwent echocardiography, exercise stress testing, 24-h Holter monitoring, signal-averaged ECG. Patients with Brugada syndrome also underwent coronary angiography and electrophysiologic study. Time domain and frequency domain HRV analysis were performed at daytime and nighttime. The results of this study showed that patients with Brugada syndrome had lower HRV or lower vagal tone at night compared to the controls. They also had lower heart rate during the day and higher during the night compared to asymptomatic subjects and the controls.

Conclusion Patients with Brugada syndrome had low heart rate variability at night which may predispose to the occurrence of VF episodes.

Key Words: Heart rate variability • Brugada syndrome • Autonomic nervous system • Sudden unexplained death syndrome


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