Even a Pooled Analysis Does Not Resolve the Debate of Electrophysiology Testing in Brugada Syndrome

Daoud, Emile G.

doi:10.1161/circulationaha.116.021174

Cited by 1 publication

(2 citation statements)

References 13 publications

(19 reference statements)

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“…Prior studies exploring the ability of EPS to predict the future risk of BrS have resulted in controversial findings . Thus, the current guidelines simply state that EPS can be used to assess whether there is a need for ICD implantation in asymptomatic patients with a spontaneous type‐1 ECG pattern .…”

Section: Resultsmentioning

confidence: 99%

“…Prior studies exploring the ability of EPS to predict the future risk of BrS have resulted in controversial findings. 46,47 Thus, the current guidelines simply state that EPS can be used to assess whether there F I G U R E 1 Flow chart of the study selection process is a need for ICD implantation in asymptomatic patients with a spontaneous type-1 ECG pattern. 48 EPS was performed at the ventricle to induce ventricular arrhythmias in nine included studies.…”

Section: Inducibility Of Vt/vfmentioning

confidence: 99%

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Brugada syndrome with SCN5A mutations exhibits more pronounced electrophysiological defects and more severe prognosis: A meta‐analysis

et al. 2019

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Whether the presence of SCN5A mutation is a predictor of BrS risk remains controversial, and patient selection bias may have weakened previous findings. Therefore, we performed this study to clarify the clinical characteristics and outcomes of BrS probands with SCN5A mutations. We systematically retrieved eligible studies published through October 2018. A total of 17 studies enrolling 1780 BrS patients were included. Overall, our results found that compared with BrS patients without SCN5A mutations, patients with SCN5A mutations exhibited a younger age at the onset of symptoms and higher rate of the spontaneous type-1 electrocardiogram pattern, more pronounced conduction or repolarization abnormalities, and increased atrial vulnerability. In addition, the presence of SCN5A mutations was associated with an elevated risk of major arrhythmic events in both Asian (odds ratio [OR] = 1.82, 95% confidence interval [CI] 1.07-3.11; P = .03) and Caucasian (OR = 2.24, 95% CI 1.02-4.90; P = .04) populations. In conclusions, patients with SCN5A mutations exhibit more pronounced electrophysiological defects and more severe prognosis.Clinicians should be cautious when utilizing genetic testing for risk stratification or treatment guidance before determining whether the causal relationship regarding SCN5A mutation status is an independent predictor of risk.

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Section: Resultsmentioning

confidence: 99%

Section: Inducibility Of Vt/vfmentioning

confidence: 99%