{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T09:55:31Z","timestamp":1778838931549,"version":"3.51.4"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,10,26]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The underlying mechanisms of Brugada syndrome (BrS) are not completely understood. Recent studies provided evidence that the electrophysiological substrate, leading to electrocardiogram abnormalities and\/or ventricular arrhythmias, is located in the right ventricular outflow tract (\n              <jats:styled-content style=\"fixed-case\">RVOT<\/jats:styled-content>\n              ). The purpose of this study was to examine abnormalities of epicardial and endocardial local unipolar electrograms by simultaneous noninvasive mapping in patients with BrS.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Local epicardial and endocardial unipolar electrograms were analyzed using a novel\n              <jats:italic>n<\/jats:italic>\n              oninvasive\n              <jats:italic>e<\/jats:italic>\n              pi\u2010 and\n              <jats:italic>e<\/jats:italic>\n              ndocardial\n              <jats:italic>e<\/jats:italic>\n              lectrophysiology\n              <jats:italic>s<\/jats:italic>\n              ystem (\n              <jats:styled-content style=\"fixed-case\">NEEES<\/jats:styled-content>\n              ) in 12 patients with BrS and 6 with right bundle branch block for comparison. Fifteen normal subjects composed the control group. Observed depolarization abnormalities included fragmented electrograms in the anatomical area of\n              <jats:styled-content style=\"fixed-case\">RVOT<\/jats:styled-content>\n              endocardially and epicardially, significantly prolonged activation time in the\n              <jats:styled-content style=\"fixed-case\">RVOT<\/jats:styled-content>\n              endocardium (65\u00b120 vs 38\u00b113\u00a0ms in controls;\n              <jats:italic>P<\/jats:italic>\n              =0.008), prolongation of the activation\u2010recovery interval in the\n              <jats:styled-content style=\"fixed-case\">RVOT<\/jats:styled-content>\n              epicardium (281\u00b134 vs 247\u00b126\u00a0ms in controls;\n              <jats:italic>P<\/jats:italic>\n              =0.002). Repolarization abnormalities included a larger area of\n              <jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content>\n              \u2010segment elevation &gt;2\u00a0mV and T\u2010wave inversions. Negative voltage gradient (\u22122.5 to \u22126.0\u00a0mV) between epicardium and endocardium of the\n              <jats:styled-content style=\"fixed-case\">RVOT<\/jats:styled-content>\n              was observed in 8 of 12 BrS patients, not present in patients with right bundle branch block or in controls.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Abnormalities of epicardial and endocardial electrograms associated with depolarization and repolarization properties were found using\n              <jats:styled-content style=\"fixed-case\">NEEES<\/jats:styled-content>\n              exclusively in the\n              <jats:styled-content style=\"fixed-case\">RVOT<\/jats:styled-content>\n              of BrS patients. These findings support both, depolarization and repolarization abnormalities, being operative at the same time in patients with BrS.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.116.004095","type":"journal-article","created":{"date-parts":[[2016,11,15]],"date-time":"2016-11-15T02:25:27Z","timestamp":1479176727000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":32,"title":["Simultaneous Non\u2010Invasive Epicardial and Endocardial Mapping in Patients With Brugada Syndrome: New Insights Into Arrhythmia Mechanisms"],"prefix":"10.1161","volume":"5","author":[{"given":"Boris","family":"Rudic","sequence":"first","affiliation":[{"name":"Department of Medicine, University Medical Center Mannheim, Mannheim, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Heidelberg\/Mannheim, Mannheim, 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Mannheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00fcrgen","family":"Kuschyk","sequence":"additional","affiliation":[{"name":"Department of Medicine, University Medical Center Mannheim, Mannheim, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Heidelberg\/Mannheim, Mannheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanne","family":"R\u00f6ger","sequence":"additional","affiliation":[{"name":"Department of Medicine, University Medical Center Mannheim, Mannheim, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Heidelberg\/Mannheim, Mannheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim","family":"El\u2010Battrawy","sequence":"additional","affiliation":[{"name":"Department of Medicine, University Medical Center Mannheim, Mannheim, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site 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