{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:32:28Z","timestamp":1790710348746,"version":"4.1.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2015,6,2]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Brugada syndrome (BrS) is a highly arrhythmogenic cardiac disorder, associated with an increased incidence of sudden death. Its arrhythmogenic substrate in the intact human heart remains ill-defined.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              Using noninvasive ECG imaging, we studied 25 BrS patients to characterize the electrophysiological substrate and 6 patients with right bundle-branch block for comparison. Seven healthy subjects provided control data. Abnormal substrate was observed exclusively in the right ventricular outflow tract with the following properties (in comparison with healthy controls;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.005): (1) ST-segment elevation and inverted T wave of unipolar electrograms (2.21\u00b10.67 versus 0 mV); (2) delayed right ventricular outflow tract activation (82\u00b118 versus 37\u00b111 ms); (3) low-amplitude (0.47\u00b10.16 versus 3.74\u00b11.60 mV) and fractionated electrograms, suggesting slow discontinuous conduction; (4) prolonged recovery time (381\u00b130 versus 311\u00b134 ms) and activation-recovery intervals (318\u00b132 versus 241\u00b127 ms), indicating delayed repolarization; (5) steep repolarization gradients (\u0394recovery time\/\u0394x=96\u00b128 versus 7\u00b16 ms\/cm, \u0394activation-recovery interval\/\u0394x=105\u00b124 versus 7\u00b15 ms\/cm) at right ventricular outflow tract borders. With increased heart rate in 6 BrS patients, reduced ST-segment elevation and increased fractionation were observed. Unlike BrS, right bundle-branch block had delayed activation in the entire right ventricle, without ST-segment elevation, fractionation, or repolarization abnormalities on electrograms.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>The results indicate that both slow discontinuous conduction and steep dispersion of repolarization are present in the right ventricular outflow tract of BrS patients. ECG imaging could differentiate between BrS and right bundle-branch block.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.114.013698","type":"journal-article","created":{"date-parts":[[2015,3,26]],"date-time":"2015-03-26T09:14:38Z","timestamp":1427361278000},"page":"1950-1959","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":159,"title":["Cardiac Electrophysiological Substrate Underlying the ECG Phenotype and Electrogram Abnormalities in Brugada Syndrome Patients"],"prefix":"10.1161","volume":"131","author":[{"given":"Junjie","family":"Zhang","sequence":"first","affiliation":[{"name":"From Cardiac Bioelectricity and Arrhythmia Center (J.Z., P.C., J.S., D.C., M.F., Y.R.) and Department of Biomedical Engineering (J.Z., Y.R.), Washington University, St. Louis, MO; Bordeaux University Hospital, LIRYC Institute, Pessac, France (F.S., M. Hocini, M. Ha\u00efssaguerre); School of Medicine, University of Wisconsin, Madison (K.H.); Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD (T.O.); CardioInsight Technologies, Cleveland, OH (M. Strom); School of Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Sacher","sequence":"additional","affiliation":[{"name":"From Cardiac Bioelectricity and Arrhythmia Center (J.Z., P.C., J.S., D.C., M.F., Y.R.) and Department of Biomedical Engineering (J.Z., Y.R.), Washington University, St. Louis, MO; Bordeaux University Hospital, LIRYC Institute, Pessac, France (F.S., M. Hocini, M. Ha\u00efssaguerre); School of Medicine, University of Wisconsin, Madison (K.H.); Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD (T.O.); CardioInsight Technologies, Cleveland, OH (M. Strom); School of Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt","family":"Hoffmayer","sequence":"additional","affiliation":[{"name":"From Cardiac Bioelectricity and Arrhythmia Center (J.Z., P.C., J.S., D.C., M.F., Y.R.) and Department of Biomedical Engineering (J.Z., Y.R.), Washington University, St. Louis, MO; Bordeaux University Hospital, LIRYC Institute, Pessac, France (F.S., M. Hocini, M. Ha\u00efssaguerre); School of Medicine, University of Wisconsin, Madison (K.H.); Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD (T.O.); CardioInsight Technologies, Cleveland, OH (M. Strom); School of Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"O\u2019Hara","sequence":"additional","affiliation":[{"name":"From Cardiac Bioelectricity and Arrhythmia Center (J.Z., P.C., J.S., D.C., M.F., Y.R.) and Department of Biomedical Engineering (J.Z., Y.R.), Washington University, St. Louis, MO; Bordeaux University Hospital, LIRYC Institute, Pessac, France (F.S., M. Hocini, M. Ha\u00efssaguerre); School of Medicine, University of Wisconsin, Madison (K.H.); Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD (T.O.); CardioInsight Technologies, Cleveland, OH (M. Strom); School of Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Strom","sequence":"additional","affiliation":[{"name":"From Cardiac Bioelectricity and Arrhythmia Center (J.Z., P.C., J.S., D.C., M.F., Y.R.) and Department of Biomedical Engineering (J.Z., Y.R.), Washington University, St. Louis, MO; Bordeaux University Hospital, LIRYC Institute, Pessac, France (F.S., M. Hocini, M. Ha\u00efssaguerre); School of Medicine, University of Wisconsin, Madison (K.H.); Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD (T.O.); CardioInsight Technologies, Cleveland, OH (M. Strom); School of Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip","family":"Cuculich","sequence":"additional","affiliation":[{"name":"From Cardiac Bioelectricity and Arrhythmia Center (J.Z., P.C., J.S., D.C., M.F., Y.R.) and Department of Biomedical Engineering (J.Z., Y.R.), Washington University, St. Louis, MO; Bordeaux University Hospital, LIRYC Institute, Pessac, France (F.S., M. Hocini, M. Ha\u00efssaguerre); School of Medicine, University of Wisconsin, Madison (K.H.); Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD (T.O.); CardioInsight Technologies, Cleveland, OH (M. Strom); School of Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Silva","sequence":"additional","affiliation":[{"name":"From Cardiac Bioelectricity and Arrhythmia Center (J.Z., P.C., J.S., D.C., M.F., Y.R.) and Department of Biomedical Engineering (J.Z., Y.R.), Washington University, St. Louis, MO; Bordeaux University Hospital, LIRYC Institute, Pessac, France (F.S., M. Hocini, M. Ha\u00efssaguerre); School of Medicine, University of Wisconsin, Madison (K.H.); Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD (T.O.); CardioInsight Technologies, Cleveland, OH (M. Strom); School of Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Cooper","sequence":"additional","affiliation":[{"name":"From Cardiac Bioelectricity and Arrhythmia Center (J.Z., P.C., J.S., D.C., M.F., Y.R.) and Department of Biomedical Engineering (J.Z., Y.R.), Washington University, St. Louis, MO; Bordeaux University Hospital, LIRYC Institute, Pessac, France (F.S., M. Hocini, M. Ha\u00efssaguerre); School of Medicine, University of Wisconsin, Madison (K.H.); Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD (T.O.); CardioInsight Technologies, Cleveland, OH (M. Strom); School of Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell","family":"Faddis","sequence":"additional","affiliation":[{"name":"From Cardiac Bioelectricity and Arrhythmia Center (J.Z., P.C., J.S., D.C., M.F., Y.R.) and Department of Biomedical Engineering (J.Z., Y.R.), Washington University, St. Louis, MO; Bordeaux University Hospital, LIRYC Institute, Pessac, France (F.S., M. Hocini, M. Ha\u00efssaguerre); School of Medicine, University of Wisconsin, Madison (K.H.); Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD (T.O.); CardioInsight Technologies, Cleveland, OH (M. Strom); School of Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e9l\u00e8ze","family":"Hocini","sequence":"additional","affiliation":[{"name":"From Cardiac Bioelectricity and Arrhythmia Center (J.Z., P.C., J.S., D.C., M.F., Y.R.) and Department of Biomedical Engineering (J.Z., Y.R.), Washington University, St. Louis, MO; Bordeaux University Hospital, LIRYC Institute, Pessac, France (F.S., M. Hocini, M. Ha\u00efssaguerre); School of Medicine, University of Wisconsin, Madison (K.H.); Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD (T.O.); CardioInsight Technologies, Cleveland, OH (M. Strom); School of Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Ha\u00efssaguerre","sequence":"additional","affiliation":[{"name":"From Cardiac Bioelectricity and Arrhythmia Center (J.Z., P.C., J.S., D.C., M.F., Y.R.) and Department of Biomedical Engineering (J.Z., Y.R.), Washington University, St. Louis, MO; Bordeaux University Hospital, LIRYC Institute, Pessac, France (F.S., M. Hocini, M. Ha\u00efssaguerre); School of Medicine, University of Wisconsin, Madison (K.H.); Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD (T.O.); CardioInsight Technologies, Cleveland, OH (M. Strom); School of Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melvin","family":"Scheinman","sequence":"additional","affiliation":[{"name":"From Cardiac Bioelectricity and Arrhythmia Center (J.Z., P.C., J.S., D.C., M.F., Y.R.) and Department of Biomedical Engineering (J.Z., Y.R.), Washington University, St. Louis, MO; Bordeaux University Hospital, LIRYC Institute, Pessac, France (F.S., M. Hocini, M. Ha\u00efssaguerre); School of Medicine, University of Wisconsin, Madison (K.H.); Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD (T.O.); CardioInsight Technologies, Cleveland, OH (M. Strom); School of Medicine,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoram","family":"Rudy","sequence":"additional","affiliation":[{"name":"From Cardiac Bioelectricity and Arrhythmia Center (J.Z., P.C., J.S., D.C., M.F., Y.R.) and Department of Biomedical Engineering (J.Z., Y.R.), Washington University, St. Louis, MO; Bordeaux University Hospital, LIRYC Institute, Pessac, France (F.S., M. Hocini, M. Ha\u00efssaguerre); School of Medicine, University of Wisconsin, Madison (K.H.); Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD (T.O.); CardioInsight Technologies, Cleveland, OH (M. 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