BACKGROUND: Among Brugada syndrome patients, asymptomatic individuals are considered to be at the lowest risk. Nevertheless, arrhythmic events and sudden cardiac death are not negligible. Literature focused on this specific group of patients is sparse. The purpose of this study is to investigate the clinical characteristics, management, and long-term prognosis of asymptomatic Brugada syndrome patients. METHODS AND RESULTS: Patients presenting with spontaneous or drug-induced Brugada type I ECG and no symptoms at our institution were considered eligible. A total of 363 consecutive patients (200 men, 55.1%; mean age, 40.9±17.2 years; 41 [11.3%] with spontaneous type I ECG) were included. Electrophysiological study was performed in 321 (88.4%) patients, and ventricular arrhythmias were induced in 32 (10%) patients. An implantable cardioverter defibrillator was implanted in 61 (16.8%) patients. After a mean follow-up time of 73.2±58.9 months, 9 arrhythmic events occurred, accounting for an annual incidence rate of 0.5%. Event-free survival was 99.0% at 1 year, 96.2% at 5 years, and 95.4% at 10 and 15 years. Univariate analysis identified as risk factors: electrophysiological study inducibility (hazard ratio, 11.4; P<0.01), spontaneous type I (hazard ratio, 4.0; P=0.04), and previous sinus node dysfunction (hazard ratio, 8.0; 95% confidence interval, 1.0-63.9; P=0.05). At the multivariate analysis, only inducibility remained significant (hazard ratio, 9.1; P<0.01). CONCLUSIONS: Arrhythmic events in asymptomatic Brugada syndrome patients are not insignificant. Ventricular arrhythmia inducibility, spontaneous type I ECG, and presence of sinus node dysfunction might be considered as risk factors and used to drive long-term management.
BACKGROUND: Among Brugada syndromepatients, asymptomatic individuals are considered to be at the lowest risk. Nevertheless, arrhythmic events and sudden cardiac death are not negligible. Literature focused on this specific group of patients is sparse. The purpose of this study is to investigate the clinical characteristics, management, and long-term prognosis of asymptomatic Brugada syndromepatients. METHODS AND RESULTS:Patients presenting with spontaneous or drug-induced Brugada type I ECG and no symptoms at our institution were considered eligible. A total of 363 consecutive patients (200 men, 55.1%; mean age, 40.9±17.2 years; 41 [11.3%] with spontaneous type I ECG) were included. Electrophysiological study was performed in 321 (88.4%) patients, and ventricular arrhythmias were induced in 32 (10%) patients. An implantable cardioverter defibrillator was implanted in 61 (16.8%) patients. After a mean follow-up time of 73.2±58.9 months, 9 arrhythmic events occurred, accounting for an annual incidence rate of 0.5%. Event-free survival was 99.0% at 1 year, 96.2% at 5 years, and 95.4% at 10 and 15 years. Univariate analysis identified as risk factors: electrophysiological study inducibility (hazard ratio, 11.4; P<0.01), spontaneous type I (hazard ratio, 4.0; P=0.04), and previous sinus node dysfunction (hazard ratio, 8.0; 95% confidence interval, 1.0-63.9; P=0.05). At the multivariate analysis, only inducibility remained significant (hazard ratio, 9.1; P<0.01). CONCLUSIONS:Arrhythmic events in asymptomatic Brugada syndromepatients are not insignificant. Ventricular arrhythmia inducibility, spontaneous type I ECG, and presence of sinus node dysfunction might be considered as risk factors and used to drive long-term management.
Authors: D M Haanschoten; A Elvan; P G Postema; J J J Smit; A Adiyaman; R M A Ter Bekke; N Asaad; W T J Aanhaanen; A R Ramdat Misier; P P H M Delnoy; H J G M Crijns; A A M Wilde Journal: Clin Res Cardiol Date: 2019-09-02 Impact factor: 5.460
Authors: Jonathan M Daw; C Anwar A Chahal; Jeffrey S Arkles; David J Callans; Sanjay Dixit; Andrew E Epstein; David S Frankel; Fermin C Garcia; Matthew C Hyman; Ramanan Kumareswaran; David Lin; Saman Nazarian; Michael P Riley; Pasquale Santangeli; Robert D Schaller; Gregory E Supple; Cory Tschabrunn; Francis E Marchlinski; Rajat Deo Journal: Heart Rhythm O2 Date: 2022-02-08
Authors: Rubén Casado Arroyo; Juan Sieira; Maciej Kubala; Decebal Gabriel Latcu; Shigo Maeda; Pedro Brugada Journal: Front Cardiovasc Med Date: 2018-11-06
Authors: Giselle G Gervacio; Jaime Alfonso Manalo Aherrera; Rody G Sy; Lauro L Abrahan Iv; Michael Joseph Agbayani; Felix Eduardo Punzalan; Elmer Jasper B Llanes; Paul Ferdinand M Reganit; Olivia T Sison; E Shyong Tai; Felicidad V Velandria; Allan Gumatay; Nina T Castillo-Carandang Journal: Heart Asia Date: 2018-05-17