Long-term prognosis of women with Brugada syndrome and electrophysiological study

Rodríguez‐Mañero, Moisés; Jordà, Paloma; Hernández, Jaime E.; Muñoz, Carmen; Grima, Esther Zorio; García-Fernández, Amaya; Cañadas-Godoy, María Victoria; Jimenez-Ramos, V; Olóriz, Teresa; Basterra, Nuria; Calvo, David; Pérez-Álvarez, Luisa; Arias, Miguel Á.; Expósito, Víctor; Alemán, Ailema; Dı́az-Infante, Ernesto; Guerra-Ramos, José M.; Fernández-Armenta, Juan; Arce-León, Álvaro; Sánchez-Gómez, Juan Miguel; Sousa, Pedro; García‐Bolao, Ignacio; Baluja, Aurora; Campuzano, Òscar; Sarquella‐Brugada, Georgia; Martínez‐Sande, José Luis; González-Juanàtey, José Ramón; Gimeno, Juan R.; Brugada, Josép; Arbelo, Elena

doi:10.1016/j.hrthm.2020.12.020

Cited by 15 publications

(9 citation statements)

References 20 publications

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“…In a multicenter retrospective study of 770 patients with Brugada syndrome, 177 (23%) were female. 139 At initial presentation, 85% were asymptomatic. Females were less likely to have a type 1 electrocardiographic pattern (31% versus 55%), but females were more likely to have a family history of SCD (49.7% versus 29.8%).…”

Section: Sudden Cardiac Arrest Ventricular Arrhythmias and Inherited ...mentioning

confidence: 99%

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Tsao¹,

Aday²,

Almarzooq³

et al. 2023

Circulation

3,153

702

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BACKGROUND: The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS: The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year’s worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year’s edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS: Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS: The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

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Section: Sudden Cardiac Arrest Ventricular Arrhythmias and Inherited ...mentioning

confidence: 99%

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Tsao¹,

Aday²,

Almarzooq³

et al. 2023

Circulation

3,153

702

View full text Add to dashboard Cite

show abstract

“…Although the prognostic value of ventricular tachyarrhythmia inducibility on an electrophysiological study (EPS) remains controversial (Viskin et al, 2021), affected females have been reported to encounter less sustained ventricular arrhythmias. (Rodríguez‐Mañero et al, 2021a) EPS‐positive females have been reported to be of a higher arrhythmic risk than their EPS‐negative counterparts. (Brugada et al, 2003; Kusumoto et al, 2018; Priori et al, 2012; Yuan et al, 2018) Furthermore, the extraction of the arrhythmic substrate under EPS was reported to be of prognostic value, suggesting that EPS may be useful in risk stratification regardless of sex differences.…”

Section: Clinical Markersmentioning

confidence: 98%

Risk stratification of sudden cardiac death in asymptomatic female Brugada syndrome patients: A literature review

Leung

Radford

Huang

et al. 2023

Noninvasive Electrocardiol

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Background and Objectives: Risk stratification in Brugada syndrome remains a difficult problem. Given the male predominance of this disease and their elevated risks of arrhythmic events, affected females have received less attention. It is widely known that symptomatic patients are at increased risk of sudden cardiac death (SCD) than asymptomatic patients, while this might be true in the male population; recent studies have shown that this association might not be significant in females. Over the past few decades, numerous markers involving clinical symptoms, electrocardiographic (ECG) indices, and genetic tests have been explored, with several risk-scoring models developed so far. The objective of this study is to review the current evidence of clinical and ECG markers as well as risk scores on asymptomatic females with Brugada syndrome.Findings: Gender differences in ECG markers, the yield of genetic findings, and the applicability of risk scores are highlighted. Conclusions:Various clinical, electrocardiographic, and genetic risk factors are available for assessing SCD risk amongst asymptomatic female BrS patients. However, due to the significant gender discrepancy in BrS, the SCD risk amongst females is often underestimated, and there is a lack of research on female-specific risk factors and multiparametric risk scores. Therefore, multinational studies pooling female BrS patients are needed for the development of a gender-specific risk stratification approach amongst asymptomatic BrS patients.

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“…The current evidence on the predictive power is mixed, varying between different patient subgroups. (10,26,27) A recent meta-analysis suggests that its risk stratification value is operator-and protocol-dependent. (28) Therefore, EPS should be applied on an individual basis with particular considerations towards patient factors, using standardized protocols with predefined locations for the placement of stimulation electrodes and the pacing protocols.…”

Section: Discussionmentioning

confidence: 99%

Comparing the performance of risk stratification scores in Brugada syndrome: a multi-centre study

Lee¹,

Zhou

Bazoukis

et al. 2021

Preprint

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IntroductionThe management of Brugada Syndrome (BrS) patients at intermediate risk of arrhythmic events remains controversial. The present study evaluated the predictive performance of different risk scores in an Asian BrS population and its intermediate risk subgroup.MethodsThis is a retrospective territory-wide cohort study of consecutive patients diagnosed with BrS from January 1st, 1997 to June 20th, 2020 in Hong Kong. The primary outcome is sustained ventricular tachyarrhythmias. A novel predictive score was developed. Machine learning-based nearest neighbor and Gaussian Naïve Bayes models were also developed. The area under the receiver operator characteristic (ROC) curve (AUC) was compared between the different scores.ResultsThe cohort consists of 548 consecutive BrS patients (7% female, age at diagnosis: 50±16 years old, follow-up duration: 84±55 months). For risk stratification in the whole BrS cohort, the score developed by Sieira et al. showed the best performance with an AUC of 0.805, followed by the Shanghai score (0.698), and the scores by Okamura et al. (0.667), Delise et al. (0.661), Letsas et al. (0.656) and Honarbakhsh et al. (0.592). A novel risk score was developed based on variables and weighting from the best performing score (the Sieira score), with the inclusion of additional variables significant on univariable Cox regression (arrhythmias other than ventricular tachyarrhythmias, early repolarization pattern in the peripheral leads, aVR sign, S-wave in lead I and QTc ≥436 ms). This score has the highest AUC of 0.855 (95% CI: 0.808-0.901). The Gaussian Naïve Bayes model demonstrated the best performance (AUC: 0.97) compared to logistic regression and nearest neighbor models.ConclusionThe inclusion of investigation results and more complex models are needed to improve the predictive performance of risk scores in the intermediate risk BrS population.

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Long-term prognosis of women with Brugada syndrome and electrophysiological study

Cited by 15 publications

References 20 publications

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Risk stratification of sudden cardiac death in asymptomatic female Brugada syndrome patients: A literature review

Comparing the performance of risk stratification scores in Brugada syndrome: a multi-centre study

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