David Calvo1, Juan Pablo Flórez2, Irene Valverde3, José Rubín4, Diego Pérez4, Mar Gonzalez Vasserot3, Julián Rodríguez-Reguero2, Pablo Avanzas2, Jesús María de la Hera2, Juan Gómez5, Eliecer Coto5, Pablo Martínez-Camblor6, César Morís2. 1. Arrhythmia Unit, Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Spain. Electronic address: dcalvo307@secardiologia.es. 2. Cardiology Department, Hospital Universitario Central de Asturias, Ovideo, Spain. 3. Arrhythmia Unit, Cardiology Department, Hospital de Cabueñes, Gijón, Spain. 4. Arrhythmia Unit, Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Spain. 5. Department of Molecular Genetics, Hospital Universitario Central de Asturias, Oviedo, Spain. 6. Department of Statistics, Hospital Universitario Central de Asturias, Oviedo, Spain; Department of statistics, Universidad Autonoma de Chile, Santiago, Chile.
Abstract
BACKGROUND: Debate regarding the prognosis of asymptomatic patients with Brugada syndrome (BrS) is possibly affected by the selection bias of survivors of sudden cardiac arrest (SCA). We aimed to determine variables influencing surveillance after SCA. METHODS: We analyzed a BrS cohort of 145 patients belonging to 37 families. We compared the clinical data and circumstances surrounding SCA (i.e., place of occurrence and people accompanying the subject) in 10 patients who survived an episode of SCA (Group A) vs. 27 deceased relatives (first or second degree) who suffered sudden cardiac death (SCD; Group B). Information concerning Group B was agreed upon by at least 3 relatives. A sub-analysis was performed considering families carrying a mutation in SCN5A (Group B-Mutant). RESULTS: Syncope was unique in predicting SCA in the BrS cohort. Comparing Groups A vs. B, there were no differences in the mean age at time of SCA/SCD (46.2 [SD 17.1] vs. 39.9 [SD 14.5] years; p=0.271), gender (male 60% vs. 74.1%; p=0.442), prior cardiomyopathy (0%), administration of cardiovascular treatments (anti-hypertensive and lipid-lowering drugs; 20% vs. 14.8%; p=0.653) or conventional cardiovascular risk factors. Environmental circumstances surrounding the SCA/SCD were not significantly different between groups. Prior syncope was more frequent in Group A (80% vs. 3.7%; p<0.001) and unique in predicting surveillance (p<0.001). Group B-Mutant displayed equivalent data. CONCLUSIONS: A previous syncope, as an alarm symptom, might contribute to better surveillance of SCA compared with subjects with SCA as the debut of BrS. The latter might behave as a factor of selection bias.
BACKGROUND: Debate regarding the prognosis of asymptomatic patients with Brugada syndrome (BrS) is possibly affected by the selection bias of survivors of sudden cardiac arrest (SCA). We aimed to determine variables influencing surveillance after SCA. METHODS: We analyzed a BrS cohort of 145 patients belonging to 37 families. We compared the clinical data and circumstances surrounding SCA (i.e., place of occurrence and people accompanying the subject) in 10 patients who survived an episode of SCA (Group A) vs. 27 deceased relatives (first or second degree) who suffered sudden cardiac death (SCD; Group B). Information concerning Group B was agreed upon by at least 3 relatives. A sub-analysis was performed considering families carrying a mutation in SCN5A (Group B-Mutant). RESULTS:Syncope was unique in predicting SCA in the BrS cohort. Comparing Groups A vs. B, there were no differences in the mean age at time of SCA/SCD (46.2 [SD 17.1] vs. 39.9 [SD 14.5] years; p=0.271), gender (male 60% vs. 74.1%; p=0.442), prior cardiomyopathy (0%), administration of cardiovascular treatments (anti-hypertensive and lipid-lowering drugs; 20% vs. 14.8%; p=0.653) or conventional cardiovascular risk factors. Environmental circumstances surrounding the SCA/SCD were not significantly different between groups. Prior syncope was more frequent in Group A (80% vs. 3.7%; p<0.001) and unique in predicting surveillance (p<0.001). Group B-Mutant displayed equivalent data. CONCLUSIONS: A previous syncope, as an alarm symptom, might contribute to better surveillance of SCA compared with subjects with SCA as the debut of BrS. The latter might behave as a factor of selection bias.
Authors: Daniel García Iglesias; Nieves Roqueñi Gutiérrez; Francisco Javier De Cos; David Calvo Journal: Sensors (Basel) Date: 2018-02-12 Impact factor: 3.576
Authors: Daniel García-Iglesias; Francisco Javier de Cos; Francisco Javier Romero; Srujana Polana; José Manuel Rubín; Diego Pérez; Julián Reguero; Jesús María de la Hera; Pablo Avanzas; Juan Gómez; Eliecer Coto; César Morís; David Calvo Journal: J Clin Med Date: 2019-10-04 Impact factor: 4.241