{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T10:28:24Z","timestamp":1758968904670,"version":"3.41.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:p>Risk stratification of patients with Brugada syndrome (BrS) remains challenging. Signal-averaged electrocardiogram (SAECG) is a noninvasive tool that can be used to identify the electrophysiologic substrate potentially underlying fatal ventricular arrhythmias. The aim of this meta-analysis is to summarize the existing evidence about the role of late potentials (LP) as a predictor for arrhythmic events in patients with BrS. A systematic search in the MedLine database through to June 2022 without any limitations was performed. Ten studies were included in the quantitative synthesis (1431 patients with BrS, mean age 47.4 years, males 86%). Of these, 1220 patients underwent SAECG evaluation (53.2% had positive LP, and 20.6% had a fatal arrhythmic event). There was a nonsignificant association between positive LPs and fatal arrhythmic events [RR: 2.06 (0.98\u20134.36), <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.06, I<jats:sup>2<\/jats:sup> = 82%]. By including only studies with patients without a history of fatal arrhythmia, the association between LP with arrhythmic events remained nonsignificant [RR: 1.29 (0.67\u20132.48), <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.44, I<jats:sup>2<\/jats:sup> = 54%]. In conclusion, there is a possible association between LP and fatal arrhythmic events in patients with BrS, but the literature remains inconclusive. Large cohort studies using a multiparametric approach for risk stratification purposes are needed to improve the risk stratification of BrS and to optimize the selection of BrS patients that should be referred for implantable cardioverter-defibrillator.<\/jats:p>","DOI":"10.1097\/crd.0000000000000511","type":"journal-article","created":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T13:26:29Z","timestamp":1696857989000},"page":"334-337","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Association of Late Potentials With Fatal Arrhythmic Events in Patients With Brugada Syndrome\u2014A Meta-analysis"],"prefix":"10.1097","volume":"32","author":[{"given":"George","family":"Bazoukis","sequence":"first","affiliation":[{"name":"Department of Cardiology, Larnaca General Hospital, Larnaca, Cyprus"},{"name":"Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos P.","family":"Letsas","sequence":"additional","affiliation":[{"name":"Arrhythmia Unit, Laboratory of Cardiac Pacing and Electrophysiology, Onassis Cardiac Surgery Center, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tong","family":"Liu","sequence":"additional","affiliation":[{"name":"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"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary","family":"Tse","sequence":"additional","affiliation":[{"name":"Kent and Medway Medical School, Canterbury, Kent, United Kingdom"},{"name":"Cardiac Electrophysiology Unit, Cardiovascular Analytics Group, China-United Kingdom Collaboration, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alawi","family":"Alsheikh-Ali","sequence":"additional","affiliation":[{"name":"College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2023,10,9]]},"reference":[{"key":"R1-20250619","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1016\/0735-1097(92)90253-J","article-title":"Right bundle branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome. A multicenter report.","volume":"20","author":"Brugada","year":"1992","journal-title":"J Am Coll Cardiol"},{"key":"R2-20250619","first-page":"100468","article-title":"Brugada syndrome: A comprehensive review of pathophysiological mechanisms and risk stratification strategies.","volume":"26","author":"Li","year":"2020","journal-title":"Int J Cardiol Heart Vasc"},{"key":"R3-20250619","doi-asserted-by":"crossref","DOI":"10.1016\/j.recesp.2022.07.003","article-title":"Brugada syndrome: 30 years of scientific adventure.","author":"Sieira","year":"2022","journal-title":"Rev Esp Cardiol (Engl Ed)"},{"key":"R4-20250619","doi-asserted-by":"crossref","first-page":"101381","DOI":"10.1016\/j.cpcardiol.2022.101381","article-title":"Comparing the Performance of Published Risk Scores in Brugada Syndrome: A Multi-center Cohort Study.","volume":"47","author":"Lee","year":"2022","journal-title":"Curr Probl Cardiol"},{"key":"R5-20250619","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1111\/pace.13214","article-title":"Prognosis, risk stratification, and management of asymptomatic individuals with Brugada syndrome: A systematic review.","volume":"40","author":"Letsas","year":"2017","journal-title":"Pacing Clin Electrophysiol"},{"key":"R6-20250619","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.jelectrocard.2008.03.001","article-title":"Ventricular late potentials: a critical overview and current applications.","volume":"41","author":"Santangeli","year":"2008","journal-title":"J Electrocardiol"},{"key":"R7-20250619","doi-asserted-by":"crossref","first-page":"e1000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med"},{"key":"R8-20250619","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1310\/tsr1401-98","article-title":"Predictors of driving ability following stroke: a systematic review.","volume":"14","author":"Marshall","year":"2007","journal-title":"Top Stroke Rehabil"},{"key":"R9-20250619","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/j.hrthm.2012.12.023","article-title":"The prognostic value of early repolarization (J wave) and ST-segment morphology after J wave in Brugada syndrome: multicenter study in Japan.","volume":"10","author":"Takagi","year":"2013","journal-title":"Heart Rhythm"},{"key":"R10-20250619","doi-asserted-by":"crossref","first-page":"1962","DOI":"10.1016\/j.amjcard.2019.03.018","article-title":"QRS Vector Magnitude as Predictor of Ventricular Arrhythmia in Patients With Brugada Syndrome.","volume":"123","author":"Ragab","year":"2019","journal-title":"Am J Cardiol"},{"key":"R11-20250619","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1536\/ihj.52.98","article-title":"Prolonged QRS duration in lead V2 and risk of life-threatening ventricular Arrhythmia in patients with Brugada syndrome.","volume":"52","author":"Ohkubo","year":"2011","journal-title":"Int Heart J"},{"key":"R12-20250619","doi-asserted-by":"crossref","first-page":"2572","DOI":"10.1253\/circj.CJ-10-0445","article-title":"SCN5A mutation is associated with early and frequent recurrence of ventricular fibrillation in patients with Brugada syndrome.","volume":"74","author":"Nishii","year":"2010","journal-title":"Circ J"},{"key":"R13-20250619","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1111\/j.1542-474X.2005.00055.x","article-title":"Noninvasive risk stratification of subjects with a Brugada-type electrocardiogram and no history of cardiac arrest.","volume":"10","author":"Ikeda","year":"2005","journal-title":"Ann Noninvasive Electrocardiol"},{"key":"R14-20250619","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1111\/pace.13587","article-title":"Prevalence of spontaneous type I ECG pattern, syncope, and other risk markers in sudden cardiac arrest survivors with Brugada syndrome.","volume":"42","author":"Leong","year":"2019","journal-title":"Pacing Clin Electrophysiol"},{"key":"R15-20250619","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1253\/circj.CJ-12-0932","article-title":"Identification of high-risk Brugada syndrome patients by combined analysis of late potential and T-wave amplitude variability on ambulatory electrocardiograms.","volume":"77","author":"Yoshioka","year":"2013","journal-title":"Circ J"},{"key":"R16-20250619","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1111\/j.1540-8167.2005.00262.x","article-title":"Relationship between dominant prolongation of the filtered QRS duration in the right precordial leads and clinical characteristics in Brugada syndrome.","volume":"16","author":"Furushima","year":"2005","journal-title":"J Cardiovasc Electrophysiol"},{"key":"R17-20250619","first-page":"1900","article-title":"Non-invasive assessment of the arrhythmogenic substrate in Brugada syndrome using signal-averaged electrocardiogram: clinical implications from a prospective clinical trial.","volume":"21","author":"Ciconte","year":"2019","journal-title":"Europace"},{"key":"R18-20250619","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1620\/tjem.240.191","article-title":"Prognostic Significance of Late Potentials in Outpatients with Type 2 Brugada Electrocardiogram.","volume":"240","author":"Nakano","year":"2016","journal-title":"Tohoku J Exp Med"},{"key":"R19-20250619","doi-asserted-by":"crossref","first-page":"1976","DOI":"10.1016\/j.jacc.2015.08.862","article-title":"Fibrosis, Connexin-43, and Conduction Abnormalities in the Brugada Syndrome.","volume":"66","author":"Nademanee","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"R20-20250619","doi-asserted-by":"crossref","first-page":"f57","DOI":"10.1093\/europace\/eux079","article-title":"Right ventricular outflow tract high-density endocardial unipolar voltage mapping in patients with Brugada syndrome: evidence for electroanatomical abnormalities.","volume":"20","author":"Letsas","year":"2018","journal-title":"Europace"},{"key":"R21-20250619","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1161\/CIRCULATIONAHA.108.771401","article-title":"High-density substrate mapping in Brugada syndrome: combined role of conduction and repolarization heterogeneities in arrhythmogenesis.","volume":"120","author":"Lambiase","year":"2009","journal-title":"Circulation"},{"key":"R22-20250619","doi-asserted-by":"crossref","first-page":"2997","DOI":"10.1111\/jce.15262","article-title":"Right ventricular outflow tract electroanatomical abnormalities in asymptomatic and high-risk symptomatic patients with Brugada syndrome: Evidence for a new risk stratification tool?","volume":"32","author":"Letsas","year":"2021","journal-title":"J Cardiovasc Electrophysiol"},{"key":"R23-20250619","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1093\/cvr\/cvaa141","article-title":"Ventricular fibrillation mechanism and global fibrillatory organization are determined by gap junction coupling and fibrosis pattern.","volume":"117","author":"Handa","year":"2021","journal-title":"Cardiovasc Res"},{"key":"R24-20250619","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1161\/01.CIR.83.4.1481","article-title":"Standards for analysis of ventricular late potentials using high-resolution or signal-averaged electrocardiography. A statement by a Task Force Committee of the European Society of Cardiology, the American Heart Association, and the American College of Cardiology.","volume":"83","author":"Breithardt","year":"1991","journal-title":"Circulation"},{"key":"R25-20250619","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/0167-5273(94)90032-9","article-title":"Late potentials, QTc prolongation, and prediction of arrhythmic events after myocardial infarction.","volume":"46","author":"Tobe","year":"1994","journal-title":"Int J Cardiol"},{"key":"R26-20250619","doi-asserted-by":"crossref","first-page":"2940","DOI":"10.1093\/eurheartj\/ehz260","article-title":"Arrhythmic risk stratification in post-myocardial infarction patients with preserved ejection fraction: the PRESERVE EF study.","volume":"40","author":"Gatzoulis","year":"2019","journal-title":"Eur Heart J"},{"key":"R27-20250619","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.jelectrocard.2022.02.009","article-title":"Predictive risk models for forecasting arrhythmic outcomes in Brugada syndrome: A focused review.","volume":"72","author":"Chung","year":"2022","journal-title":"J Electrocardiol"},{"key":"R28-20250619","doi-asserted-by":"crossref","first-page":"e005928","DOI":"10.1161\/CIRCEP.117.005928","article-title":"Right Ventricular Outflow Tract Electroanatomical Abnormalities Predict Ventricular Fibrillation Inducibility in Brugada Syndrome.","volume":"11","author":"Letsas","year":"2018","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"R29-20250619","doi-asserted-by":"crossref","first-page":"1992","DOI":"10.1016\/S0735-1097(02)01888-0","article-title":"Epicardial electrogram of the right ventricular outflow tract in patients with the Brugada syndrome: using the epicardial lead.","volume":"39","author":"Nagase","year":"2002","journal-title":"J Am Coll Cardiol"},{"key":"R30-20250619","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1016\/j.hrthm.2009.05.007","article-title":"Role of signal-averaged electrocardiograms in arrhythmic risk stratification of patients with Brugada syndrome: a prospective study.","volume":"6","author":"Huang","year":"2009","journal-title":"Heart Rhythm"},{"key":"R31-20250619","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1046\/j.1540-8167.2005.04313.x","article-title":"Assessment of markers for identifying patients at risk for life-threatening arrhythmic events in Brugada syndrome.","volume":"16","author":"Ajiro","year":"2005","journal-title":"J Cardiovasc Electrophysiol"},{"key":"R32-20250619","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1002\/joa3.12118","article-title":"Tpeak-Tend, Tpeak-Tend\/QT ratio and Tpeak-Tend dispersion for risk stratification in Brugada Syndrome: A systematic review and meta-analysis.","volume":"34","author":"Tse","year":"2018","journal-title":"J Arrhythm"},{"key":"R33-20250619","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.ijcard.2019.12.047","article-title":"Risk stratification in Brugada syndrome - Significance of ECG and depolarization abnormality.","volume":"303","author":"Nagase","year":"2020","journal-title":"Int J Cardiol"},{"key":"R34-20250619","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1016\/j.hrthm.2022.01.034","article-title":"SCN5A mutation in Brugada syndrome is associated with substrate severity detected by electrocardiographic imaging and high-density electroanatomic mapping.","volume":"19","author":"Pannone","year":"2022","journal-title":"Heart Rhythm"}],"container-title":["Cardiology in Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/CRD.0000000000000511","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T16:03:09Z","timestamp":1750348989000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/CRD.0000000000000511"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,9]]},"references-count":34,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.1097\/crd.0000000000000511","relation":{},"ISSN":["1061-5377"],"issn-type":[{"type":"print","value":"1061-5377"}],"subject":[],"published":{"date-parts":[[2023,10,9]]}}}