Takeshi Kitamura1, Seiji Fukamizu2, Iwanari Kawamura2, Rintaro Hojo2, Yuya Aoyama2, Mitsuhiro Nishizaki3, Masayasu Hiraoka4, Harumizu Sakurada5. 1. Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan. Electronic address: take1124@hotmail.co.jp. 2. Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan. 3. Department of Cardiology, Yokohama Minami Kyosai Hospital, Yokohama, Japan. 4. Tokyo Medical and Dental University, Yushima, Tokyo, Japan. 5. Tokyo Metropolitan Health and Medical Treatment Corporation, Ohkubo Hospital, Tokyo, Japan.
Abstract
OBJECTIVES: This study investigated clinical characteristics and prognosis of Brugada syndrome (BrS) in patients older than 60 years of age during a long-term follow-up period. BACKGROUND: Clinical characteristics and prognosis of senior patients with BrS have not been clearly elucidated. METHODS: A total of 181 patients with BrS were divided into 2 groups by age at the time of diagnosis: the younger group was <60 years of age (n = 123), and the senior group was ≥60 years of age (n = 58). RESULTS: Mean ages were 42.7 ± 11 years and 68.6 ± 7.1 years, respectively. Prevalence of spontaneous type 1 electrocardiogram (ECG) was lower in the senior group (22 of 58; 37.9%) than in the younger group (64 of 123; 51.9%) (p = 0.027). Among various ECG parameters, the senior group had a lower incidence of prolonged r-J intervals in V2 ≥90 ms than the younger group (34 of 58; 58.6% vs. 90 of 123; 73.1%, p = 0.049) and day-to-day variation of Brugada ECG patterns (3 of 58; 5.2% vs. 23 of 123; 18.7%, p = 0.032). During a mean follow-up period of 7.6 ± 5.8 years, no senior patients experienced documented fatal ventricular arrhythmias, but 11 younger patients did. Kaplan-Meier analysis revealed a better prognosis in the senior group than in the younger group (log-rank, p = 0.011). CONCLUSIONS: Senior BrS patients, ≥60 years of age, had a better prognosis than those <60 years of age. Implantable cardioverter-defibrillator insertion for senior patients with BrS needs careful consideration.
OBJECTIVES: This study investigated clinical characteristics and prognosis of Brugada syndrome (BrS) in patients older than 60 years of age during a long-term follow-up period. BACKGROUND: Clinical characteristics and prognosis of senior patients with BrS have not been clearly elucidated. METHODS: A total of 181 patients with BrS were divided into 2 groups by age at the time of diagnosis: the younger group was <60 years of age (n = 123), and the senior group was ≥60 years of age (n = 58). RESULTS: Mean ages were 42.7 ± 11 years and 68.6 ± 7.1 years, respectively. Prevalence of spontaneous type 1 electrocardiogram (ECG) was lower in the senior group (22 of 58; 37.9%) than in the younger group (64 of 123; 51.9%) (p = 0.027). Among various ECG parameters, the senior group had a lower incidence of prolonged r-J intervals in V2 ≥90 ms than the younger group (34 of 58; 58.6% vs. 90 of 123; 73.1%, p = 0.049) and day-to-day variation of Brugada ECG patterns (3 of 58; 5.2% vs. 23 of 123; 18.7%, p = 0.032). During a mean follow-up period of 7.6 ± 5.8 years, no senior patients experienced documented fatal ventricular arrhythmias, but 11 younger patients did. Kaplan-Meier analysis revealed a better prognosis in the senior group than in the younger group (log-rank, p = 0.011). CONCLUSIONS: Senior BrS patients, ≥60 years of age, had a better prognosis than those <60 years of age. Implantable cardioverter-defibrillator insertion for senior patients with BrS needs careful consideration.