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Analysis of a Family with Brugada Syndrome and Sudden Cardiac Death Caused by a Novel Mutation of SCN5A. Cardiol Res Pract 2022; 2022:9716045. [PMID: 35529058 PMCID: PMC9072018 DOI: 10.1155/2022/9716045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 03/19/2022] [Accepted: 04/06/2022] [Indexed: 11/17/2022] Open
Abstract
Background. Brugada syndrome is a hereditary cardiac disease associated with mutations in ion channel genes. The clinical features include ventricular fibrillation, syncope, and sudden cardiac death. A family with Brugada syndrome with sudden cardiac death was analyzed to locate the associated mutation in the SCN5A gene. Methods and Results. Three generations of a Han Chinese family with Brugada syndrome were recruited in the study; their clinical phenotype data were collected and DNA samples extracted from the peripheral blood. Next-generation sequencing was carried out in the proband, and candidate genes and mutations were screened using the full exon capture technique. The family members who participated in the survey were tested for possible mutations using Sanger sequencing. Six family members were diagnosed with Brugada syndrome, including four asymptomatic patients. A newly discovered heterozygous mutation in the proband was located in exon 25 of SCN5A (NM_000335.5) at c.4313dup(p.Trp1439ValfsTer32). Among the surviving family members, only those with a Brugada wave on their electrocardiogram carried the c.4313dup(p.Trp1439ValfsTer32) variant. Bioinformatics prediction revealed that the frameshift of the c.4313dup (p.Trp1439ValfsTer32) mutant led to a coding change of 32 amino acids, followed by a stop codon, resulting in a truncated protein product. Conclusion. The newly discovered mutation site c.4313dup(p.Trp1439ValfsTer32) in exon 25 of SCN5A may be the molecular genetic basis of the family with Brugada syndrome.
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2
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Spectral Analysis of the QT Interval Increases the Prediction Accuracy of Clinical Variables in Brugada Syndrome. J Clin Med 2019; 8:jcm8101629. [PMID: 31590333 PMCID: PMC6833061 DOI: 10.3390/jcm8101629] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 09/27/2019] [Accepted: 09/30/2019] [Indexed: 12/27/2022] Open
Abstract
(1) Background: The clinical management of Brugada Syndrome (BrS) remains suboptimal. (2) Objective: To explore the role of standard electrocardiogram (ECG) spectral analysis in diagnosis and risk stratification. (3) Methods: We analyzed 337 patients—43 with a spontaneous type I ECG pattern (Spont-BrS), 112 drug induced (Induct-BrS), and 182 with a negative response to the drug challenge (negative responders (NR)). ECGs were processed using the wavelet transform (high frequency: 85 to 130 Hz). (4) Results: The power of the high-frequency content in the ST segment (Total ST Power; nV2Hz−1103) was higher in BrS compared with NR patients (Spont-BrS: 28.126 (7.274–48.978) vs. Induc-BrS: 26.635 (15.846–37.424) vs. NR: 11.13 (8.917–13.343); p = 0.002). No differences were observed between ECG patterns in BrS patients. However, the Total ST Power of the type II or III ECG in NR patients was lower than in the same ECG patterns recorded from BrS patients (BrS: 31.07 (16.856–45.283); vs. NR: 10.8 (7.248–14.352) nV2Hz−1103; p = 0.007). The Total ST Power, age, and family history of BrS were independent predictors of positive responses to drug testing. Comparing models with versus those without Total ST Power, the area under the received operator curve (ROC) curve increased (with 0.607 vs. without 0.528, p = 0.001). Only syncope was associated with an increased risk (follow-up 55.8 ± 39.35 months). However, the area under the ROC curve increased significantly when the Total ST Power was included as a covariate (with 0.784 vs. without 0.715, p = 0.04). (5) Conclusions: The analysis of the high-frequency content of ECG signals increases the predictive capability of clinical variables in BrS patients.
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3
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Iglesias DG, Rubín J, Pérez D, Morís C, Calvo D. Insights for Stratification of Risk in Brugada Syndrome. Eur Cardiol 2019; 14:45-49. [PMID: 31131036 PMCID: PMC6523056 DOI: 10.15420/ecr.2018.31.2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Brugada syndrome (BrS) is an inherited disease with an increased risk of sudden cardiac death (SCD). However, testing identifies genetic disorders in only 20-30% of patients analysed, indicating a gap in knowledge of its genetic aetiology. Diagnosis relies on ECG, and risk stratification in BrS patients is challenging, primarily because of the complexity of the issue. As a result, clinicians fail to provide the appropriate strategy for SCD prevention for many patients. Several variables and interventions are being studied to improve diagnostics and maximise patient protection. In addition, the scientific community must increase efforts to provide patient care according to knowledge and research for improving stratification of risk. In this article, the authors summarise contemporary evidence on clinical variables and provide an overview of future directions in risk stratification and SCD prevention.
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Affiliation(s)
- Daniel García Iglesias
- Arrhythmia Unit, Cardiology Department, Hospital Universitario Central de Asturias Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias Oviedo, Spain
| | - José Rubín
- Arrhythmia Unit, Cardiology Department, Hospital Universitario Central de Asturias Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias Oviedo, Spain
| | - Diego Pérez
- Arrhythmia Unit, Cardiology Department, Hospital Universitario Central de Asturias Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias Oviedo, Spain
| | - César Morís
- Arrhythmia Unit, Cardiology Department, Hospital Universitario Central de Asturias Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias Oviedo, Spain
| | - David Calvo
- Arrhythmia Unit, Cardiology Department, Hospital Universitario Central de Asturias Oviedo, Spain.,Instituto de Investigación Sanitaria del Principado de Asturias Oviedo, Spain
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4
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Li X, Sacher F, Kusano KF, Barajas-Martinez H, Liu N, Li Y, Gao Y, Liu T, Shang H, Antzelevitch C, Hu D, Xing Y. Pooled Analysis of Risk Stratification of Spontaneous Type 1 Brugada ECG: Focus on the Influence of Gender and EPS. Front Physiol 2019; 9:1951. [PMID: 30766491 PMCID: PMC6365464 DOI: 10.3389/fphys.2018.01951] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 12/22/2018] [Indexed: 11/13/2022] Open
Abstract
Aims: Risk stratification of patients with Brugada syndrome (BrS) is vital for accurate prognosis and therapeutic decisions. Spontaneous Type 1 ST segment elevation is generally considered to be an independent risk factor for arrhythmic events. Other risk factors include gender, syncope, sudden cardiac arrest (SCA), and positive electrophysiological study (EPS). However, the further risk stratification of spontaneous type 1 combined with the other risk factors remains unclear. The present study pooled data from 4 large trials aiming to systematically evaluate the risk of spontaneous Type-1 ECG when combined with one or more of these other recognized risk factors. Methods: We searched for related studies published from November 2, 2002 to February 10, 2018 in PubMed, EMBASE, Cochrane Library, MEDLINE, Chinese National Knowledge Infrastructure (CNKI), and Wanfang Databases. The pooled data were evaluated combining each risk factor with the presence of a spontaneous Type-1 ECG. All analyses were performed using Review Manager, version 5.0.12. Results: Four eligible studies involving 1,338 patients (85% males, mean age: 48.1 ± 18.1 years) were enrolled. Spontaneous Type-1 ECG was associated with higher risk for ventricular tachycardia/fibrillation (VT/VF) than cases with non-Type 1 ECG in males (odds ratio: 95% CI: 1.84–5.17; P < 0.0001), but not in females (P = 0.29). Among spontaneous Type-1 cases with syncope or with positive EPS, the difference was not statistically significant (P = 0.06 and 0.07, respectively). Patients with Type-1 ECGs and positive EPS were at higher risk than those with negative EPS (95% CI: 1.10–5.04; P = 0.03). Pooled analysis showed an association of Spontaneous Type-1 ECG, Type-1 ECGs combined with male, and Type-1 ECGs combined with positive EPS between increased risk of arrhythmic events. Conclusion: Our results indicate that in BrS patients, a spontaneous Type-1 ECG is an independent risk factor for SCD in males, but not in females. A spontaneous Type-1 BrS is associated with a worse prognosis when combined with positive EPS
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Affiliation(s)
- Xinye Li
- Guang'anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China.,College of Acupuncture and Massage, Beijing University of Chinese Medicine, Beijing, China
| | - Frédéric Sacher
- Hôpital Cardiologique Haut Lévêque, Lyric Institute, Université de Bordeaux, Bordeaux-Pessac, France
| | - Kengo F Kusano
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | | | - Nian Liu
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yanda Li
- Guang'anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Yonghong Gao
- The Key Laboratory of Chinese Internal Medicine of the Ministry of Education, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Tong Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Hongcai Shang
- The Key Laboratory of Chinese Internal Medicine of the Ministry of Education, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Charles Antzelevitch
- Lankenau Institute for Medical Research and Jefferson Medical College, Philadelphia, PA, United States
| | - Dan Hu
- Department of Cardiology and Cardiovascular Research Institute, Renmin Hospital of Wuhan University, Wuhan, China.,Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Yanwei Xing
- Guang'anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
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5
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Yuan M, Tian C, Li X, Yang X, Wang X, Yang Y, Liu N, Kusano KF, Barajas-Martinez H, Hu D, Shang H, Gao Y, Xing Y. Gender Differences in Prognosis and Risk Stratification of Brugada Syndrome: A Pooled Analysis of 4,140 Patients From 24 Clinical Trials. Front Physiol 2018; 9:1127. [PMID: 30246798 PMCID: PMC6113678 DOI: 10.3389/fphys.2018.01127] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 07/27/2018] [Indexed: 12/23/2022] Open
Abstract
Background: Male gender has been consistently shown to be a risk factor for a greater number of arrhythmic events in patients with Brugada Syndrome (BrS). However, there have been no large-scale comprehensive pooled analyses to statistically and systematically verify this association. Therefore, we conducted a pooled analysis on gender differences in prognosis and risk stratification of BrS with a largest sample capacity at present. Methods: We searched PubMed, Embase, Medline, Cochrane Library databases, Chinese National Knowledge Infrastructure, and Wanfang Data for relevant studies published from 2002 to 2017. The prognosis and risk stratification of BrS and risk factors were then investigated and evaluated according to gender. Results: Twenty-four eligible studies involving 4,140 patients were included in the analysis. Male patients (78.1%) had a higher risk of arrhythmic events than female patients (95% confidence interval: 1.46–2.91, P < 0.0001). Among the male population, there were statistical differences between symptomatic patients and asymptomatic patients (95% CI: 2.63–7.86, P < 0.00001), but in the female population, no statistical differences were found. In the female subgroup, electrophysiological study (EPS) positive patients had a tendency toward a higher risk of arrhythmic events than EPS-negative patients (95% CI: 0.93–29.77, P = 0.06). Conclusions: Male patients are at a higher risk of arrhythmic events than female patients. Within the male population, symptomatic patients have a significantly higher risk profile compared to asymptomatic patients, but no such differences are evident within the female population. Consequently, in the female population, the risk of asymptomatic patterns cannot be underestimated.
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Affiliation(s)
- Mengchen Yuan
- Guang'anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China.,Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Chao Tian
- Guang'anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China.,Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Xinye Li
- Guang'anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Xinyu Yang
- Guang'anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China.,Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Xiaofeng Wang
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Yihan Yang
- Guang'anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China.,Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Nian Liu
- Department of Cardiology, Beijing An Zhen Hospital of the Capital University of Medical Sciences, Beijing, China
| | - Kengo F Kusano
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | | | - Dan Hu
- Masonic Medical Research Laboratory, Utica, NY, United States.,Hubei Key Laboratory of Cardiology, Department of Cardiology and Cardiovascular Research Institute, Renmin Hospital of Wuhan University, Wuhan, China
| | - Hongcai Shang
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Yonghong Gao
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Yanwei Xing
- Guang'anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
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Analysis of the High-Frequency Content in Human QRS Complexes by the Continuous Wavelet Transform: An Automatized Analysis for the Prediction of Sudden Cardiac Death. SENSORS 2018; 18:s18020560. [PMID: 29439530 PMCID: PMC5854972 DOI: 10.3390/s18020560] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 02/06/2018] [Accepted: 02/07/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Fragmentation and delayed potentials in the QRS signal of patients have been postulated as risk markers for Sudden Cardiac Death (SCD). The analysis of the high-frequency spectral content may be useful for quantification. METHODS Forty-two consecutive patients with prior history of SCD or malignant arrhythmias (patients) where compared with 120 healthy individuals (controls). The QRS complexes were extracted with a modified Pan-Tompkins algorithm and processed with the Continuous Wavelet Transform to analyze the high-frequency content (85-130 Hz). RESULTS Overall, the power of the high-frequency content was higher in patients compared with controls (170.9 vs. 47.3 10³nV²Hz-1; p = 0.007), with a prolonged time to reach the maximal power (68.9 vs. 64.8 ms; p = 0.002). An analysis of the signal intensity (instantaneous average of cumulative power), revealed a distinct function between patients and controls. The total intensity was higher in patients compared with controls (137.1 vs. 39 10³nV²Hz-1s-1; p = 0.001) and the time to reach the maximal intensity was also prolonged (88.7 vs. 82.1 ms; p < 0.001). DISCUSSION The high-frequency content of the QRS complexes was distinct between patients at risk of SCD and healthy controls. The wavelet transform is an efficient tool for spectral analysis of the QRS complexes that may contribute to stratification of risk.
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7
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Abstract
Ventricular arrhythmias remain a significant cause of sudden cardiac death (SCD), and knowledge of their cause and high-risk features is important. SCD occurs when the interaction between vulnerable substrates and acute triggers results in sustained ventricular tachycardia progressing to ventricular fibrillation. Here, the authors aim to review the role of ventricular arrhythmias in SCD, first by approaching the substrates that support ventricular arrhythmias, and then by exploring features of these substrates and the acute triggers that may lead to SCD.
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Affiliation(s)
- Pok Tin Tang
- UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
| | | | - Noel G Boyle
- UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
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8
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Pablo Flórez J, García D, Valverde I, Rubín J, Pérez D, González-Vasserot M, Reguero J, María de la Hera J, Avanzas P, Gómez J, Coto E, Morís C, Calvo D. Role of syncope in predicting adverse outcomes in patients with suspected Brugada syndrome undergoing standardized flecainide testing. Europace 2017; 20:f64-f71. [DOI: 10.1093/europace/eux315] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 09/11/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
- Juan Pablo Flórez
- Department of Cadiology, Hospital Universitario Central de Asturias, C/Avd de Roma, s/n, 33006 Oviedo, Spain
| | - Daniel García
- Department of Cadiology, Hospital Universitario Central de Asturias, C/Avd de Roma, s/n, 33006 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, C/Avd de Roma, s/n, 33006 Oviedo, Spain
| | - Irene Valverde
- Instituto de Investigación Sanitaria del Principado de Asturias, C/Avd de Roma, s/n, 33006 Oviedo, Spain
- Department of Cadiology, Hospital de Cabueñes, C/Los Prados, 395, 33394 Gijón, Asturias, Spain
| | - José Rubín
- Department of Cadiology, Hospital Universitario Central de Asturias, C/Avd de Roma, s/n, 33006 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, C/Avd de Roma, s/n, 33006 Oviedo, Spain
| | - Diego Pérez
- Department of Cadiology, Hospital Universitario Central de Asturias, C/Avd de Roma, s/n, 33006 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, C/Avd de Roma, s/n, 33006 Oviedo, Spain
| | - Mar González-Vasserot
- Instituto de Investigación Sanitaria del Principado de Asturias, C/Avd de Roma, s/n, 33006 Oviedo, Spain
- Department of Cadiology, Hospital de Cabueñes, C/Los Prados, 395, 33394 Gijón, Asturias, Spain
| | - Julián Reguero
- Department of Cadiology, Hospital Universitario Central de Asturias, C/Avd de Roma, s/n, 33006 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, C/Avd de Roma, s/n, 33006 Oviedo, Spain
| | - Jesús María de la Hera
- Department of Cadiology, Hospital Universitario Central de Asturias, C/Avd de Roma, s/n, 33006 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, C/Avd de Roma, s/n, 33006 Oviedo, Spain
| | - Pablo Avanzas
- Department of Cadiology, Hospital Universitario Central de Asturias, C/Avd de Roma, s/n, 33006 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, C/Avd de Roma, s/n, 33006 Oviedo, Spain
| | - Juan Gómez
- Instituto de Investigación Sanitaria del Principado de Asturias, C/Avd de Roma, s/n, 33006 Oviedo, Spain
- Department of Molecular Genetics, Hospital Universitario Central de Asturias, C/Avd. de Roma, s/n, 33006 Oviedo, Spain
| | - Eliecer Coto
- Instituto de Investigación Sanitaria del Principado de Asturias, C/Avd de Roma, s/n, 33006 Oviedo, Spain
- Department of Molecular Genetics, Hospital Universitario Central de Asturias, C/Avd. de Roma, s/n, 33006 Oviedo, Spain
| | - César Morís
- Department of Cadiology, Hospital Universitario Central de Asturias, C/Avd de Roma, s/n, 33006 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, C/Avd de Roma, s/n, 33006 Oviedo, Spain
| | - David Calvo
- Department of Cadiology, Hospital Universitario Central de Asturias, C/Avd de Roma, s/n, 33006 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, C/Avd de Roma, s/n, 33006 Oviedo, Spain
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Cay S, Aras D, Topaloglu S, Ozcan F, Ozeke O. Early repolarization syndrome and Brugada syndrome: Similar or different? Int J Cardiol 2017; 229:9. [PMID: 27940004 DOI: 10.1016/j.ijcard.2016.11.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 11/29/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Serkan Cay
- Department of Cardiology, Division of Arrhythmia and Electrophysiology, Yuksek Ihtisas Heart-Education and Research Hospital, Ankara, Turkey.
| | - Dursun Aras
- Department of Cardiology, Division of Arrhythmia and Electrophysiology, Yuksek Ihtisas Heart-Education and Research Hospital, Ankara, Turkey
| | - Serkan Topaloglu
- Department of Cardiology, Division of Arrhythmia and Electrophysiology, Yuksek Ihtisas Heart-Education and Research Hospital, Ankara, Turkey
| | - Firat Ozcan
- Department of Cardiology, Division of Arrhythmia and Electrophysiology, Yuksek Ihtisas Heart-Education and Research Hospital, Ankara, Turkey
| | - Ozcan Ozeke
- Department of Cardiology, Division of Arrhythmia and Electrophysiology, Yuksek Ihtisas Heart-Education and Research Hospital, Ankara, Turkey
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10
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La Rocca R, Campedel F, Materia V, Saggese MP, Patanè S. Theophylline and syncope. Int J Cardiol 2016; 223:149-151. [PMID: 27537745 DOI: 10.1016/j.ijcard.2016.08.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 08/03/2016] [Indexed: 11/15/2022]
Affiliation(s)
- Roberto La Rocca
- Pronto Soccorso/D.E.A. - Chiari-Iseo (BS) ASST Franciacorta, viale Giuseppe Mazzini 4, 25032 Chiari (Brescia), Italy.
| | - Fulvia Campedel
- Pronto Soccorso/D.E.A. - Chiari-Iseo (BS) ASST Franciacorta, viale Giuseppe Mazzini 4, 25032 Chiari (Brescia), Italy
| | - Valeria Materia
- Terapia Intensiva Neonatale ASST Spedali Civili (Brescia), Piazzale Spedali Civili 1, 25123 Brescia (BS), Italy
| | - Maria Paola Saggese
- Pronto Soccorso/D.E.A. - Chiari-Iseo (BS) ASST Franciacorta, viale Giuseppe Mazzini 4, 25032 Chiari (Brescia), Italy
| | - Salvatore Patanè
- Cardiologia Ospedale San Vincenzo - Taormina (Me) Azienda Sanitaria Provinciale di Messina, Contrada Sirina, 98039 Taormina (Messina), Italy
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