Rhythmic Risk of Type 1 Brugada Syndrome and Pulmonary Infundibulum Mapping (SB-CARTO)

Assessment of Rhythmic Risk in Patients With Type 1 Brugada Syndrome by Pulmonary Infundibulum Mapping

Brugada syndrome has been described as the association of a right bundle block with ST segment elevation on the V1 to V3 electrocardiogram in patients with a structurally normal heart. The rhythmic risk is thus difficult to evaluate in asymptomatic patients in whom the rate of events is estimated at 0.2 to 1.4% of events per year. In addition, the predictive value of ventricular pacing remains controversial; There is therefore currently no review to effectively assess rhythmic risk in patients with Brugada type I syndrome. Investigators aimed to show a difference in pulmonary infundibulum voltage mapping in symptomatic and asymptomatic patients with Brugada type 1 syndrome with a comparable ECG. The mapping of the pulmonary infundibulum will be performed during electrophysiological exploration. Only the catheter used differs from the usual procedure.

An endocardial mapping of the pulmonary infundibulum will be performed during the electrophysiological exploration between asymptomatic patients with Brugada type 1 and patients with symptomatic Brugada type 1.

Identification of different voltage zones by endocardial mapping of the pulmonary infundibulum between asymptomatic patients with Brugada type 1 and patients with symptomatic Brugada type 1

The voltage zone are defined with : measurement of unipolar and bipolar local voltage (mV) the scar surface the surface of the bordering area the surface of healthy tissue the quantification of the number of fractionated potentials and density with respect to the size of the infundibulum and the scar (if present) the analysis of the heterogeneity of the voltage (study of dispersion) analysis of propagation card velocities in sinus rhythm and ventricular pacing (mm / s) analysis of ventricular arrhythmia activation if positive ventricular pacing and good hemodynamic tolerance (focal / reentrant / reentrant macro).

Inclusion Criteria: Group 21 Brugada Type 1 syndrome Age : 50-60 years old Asymptomatic Signed informed consent Group2 Brugada Type 1 syndrome Age >18 years old Implantable defibrillator Having received at least 1 appropriate shock or a sudden sudden death Signed informed consent Groups 1 and 2 Exclusion Criteria: Brugada Type 2 or 3 syndrome Contraindication to electrophysiological exploration