TORNA ALL’ELENCO

Long-term prognosis of brugada syndrome patients: Results from the finger registry in Heart Rhythm

2009
ASL Asti

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (12)Vedi tutti...

Probst V
L'institut du thorax, Nantes, France, Nantes, France
Gaita F
L'institut du thorax, Nantes, France, Nantes, France
Veltmann C
L'institut du thorax, Nantes, France, Nantes, France

et alii...

Abstract

Introduction: Brugada syndrome is characterized by a right precordial ST-segment elevation and an augmented risk of sudden cardiac death (SCD). Fundamental questions remain on the evaluation of the disease-associated arrhythmic risk. The aim of this retrospective study was to assess the prognosis of patients affected by BrS in a large registry containing data from 4 different European countries. Furthermore, we aimed to investigate whether inducibility of ventricular tachyarrhythmia at EPS is a valid predictor of arrhythmic events, defined as SCD or appropriate ICD shocks. Methods: Inclusion criteria consisted of a type-1 ECG, after exclusion of diseases that can mimick BrS. Type I ECG could be present either at baseline or after drug challenge with a class IA or IC sodium channel blocker. At least one follow-up must be available. Results: The registry included 1029 individuals (745 males; 72%) with a mean age of 44±14 years. Circumstances of diagnosis were: 1) aborted-SCD due to ventricular fibrillation (6%), 2) syncope, otherwise unexplained (30%) 3) asymptomatic patients diagnosed because of familial screening or systematic ECG (64%). A spontaneous type 1 ECG was found in 45% of the patients. EPS has been performed in 638 individuals (62%) and was positive in 262 (41%). During a mean follow-up of 37+/-28 months, 51 events occurred (44 patients experienced appropriate ICD shocks and 7 died suddenly). The mean event rate per year was 7.7% in patients identified after aborted-SCD, 1.87% in patients identified after syncope and 0.5% in asymptomatic patients. Symptoms, age at diagnosis for the asymptomatic patients, spontaneous type 1 ECG and an ICD implant were the only parameters predictive of arrhythmic events whereas gender, familial history of sudden death, inducibility of ventricular tachyarrhythmia and the presence of a mutation in the SCN5A gene had no predictive value. Conclusions: In the largest BrS series so far, event rate in asymptomatic patients

Keywords

sodium channel blocking agent; register; patient; heart rhythm; Brugada syndrome; prognosis; society; electrocardiogram; heart ventricle tachycardia; risk; sudden death; follow up; diagnosis; faintness; ST segment elevation; screening; implant; gender; mutation; gene; predictive value; family history; consensus; retrospective study; male; heart ventricle fibrillation;