Magnetocardiography study on ventricular depolarization-current pattern in patients with Brugada syndrome and complete right-bundle branch blocks

Background: The objective of this study is to use magnetocardiography to determine the existence of a small abnormal current during ventricular depolarization in patients with Brugada syndrome. To understand this small difference in abnormal current during ventricular depolarization, we compared abnormal currents of patients with cases of complete right-bundle-branch block (CRBBB). Methods and Results: We developed a whole-heart electrical bull's eye map (WHEBEM) that uses magnetocardiograms (MCGs) to visualize the current distribution in a circular map. MCGs of Brugada syndrome patients (n = 16), CRBBB patients (n = 10), and controls (n = 12) at rest were recorded. In the WHEBEMs of Brugada syndrome patients, the magnitude of the S-wave current in the upper-right direction of the anterior side is larger than that of the controls. In addition, the R-wave current direction is similar to that of the controls, and the R-wave vector is distributed over a larger area than that of the controls. On the other hand, the CRBBB patients have a distribution of R-wave currents over a larger area in the left anteromedian region and the left posteromedian region. Moreover, in all CRBBB patients, S-wave currents with a large magnitude have the same direction distributed over a small area. Conclusions: The WHEBEM findings suggest that there is an abnormal current in the direction to the upper right (in the S-wave) in the anterosuperior region of Brugada syndrome patients. We thus conclude that a WHEBEM has the potential to detect characteristics of heart disease.