Prevalence and prognosis of subjects with brugada-type ECG pattern in a young and middle-aged finnish population

Junttila, M. Juhani; Raatikainen, M.J. Pekka; Karjalainen, Jaana; Kauma, Heikki; Kesäniemi, Y. Antero; Huikuri, Heikki V.

doi:10.1016/j.accreview.2004.07.089

Cited by 25 publications

(36 citation statements)

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“…Similarly, Juntilla et al [8] in 15 Finnish subjects with Type 2 or 3 Brugada-type ECG found an excellent prognosis in a retrospective follow-up of 19 ± 2 years. Therefore, at present two opposite views exists with regard to prognosis and risk stratification in patients with this ECG pattern.…”

Section: Prognosis Of the Brugada-type Ecgmentioning

confidence: 88%

“…Additional reports, suggest a more benign course especially in non-hospital-based populations [6][7][8][11][12][13][14]. There are still many unanswered questions regarding epidemiology and specificity of this ECG pattern in identifying individuals likely to develop ventricular arrhythmias.…”

Section: Introductionmentioning

confidence: 94%

“…The consensus report of the Study Group of the Molecular Basis of Arrhythmias laid down precise diagnostic criteria for the Brugada-type ECG, recognizing three variants of the repolarization pattern in chest leads V1-V3 (type 1: classical convex ST elevation of ≥ 2 mm, type 2: J wave amplitude ≥ 2 mm with concave ST elevation ≥ 1 mm, and type 3: J point elevation with the ST segment isoelectric or elevated by b1 mm) [2,3]. To our knowledge only one European survey, conducted in Finland, has applied these criteria [8]. The authors of this study concluded that in Scandinavian countries, where no case of Brugada Syndrome has been described, concave ST elevation in healthy males is not uncommon and it may be considered a normal variant.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and significance of Brugada-type ECG in 12,012 apparently healthy European subjects

Gallagher

Forleo

Behr

et al. 2008

International Journal of Cardiology

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Section: Prognosis Of the Brugada-type Ecgmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

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Prevalence and significance of Brugada-type ECG in 12,012 apparently healthy European subjects

Gallagher

Forleo

Behr

et al. 2008

International Journal of Cardiology

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“…It is particularly prevalent in Japan and Thailand, [5,11] while in China and Korea the reported incidence is lower [12,13]. In Europe, it is extensively described [14,15], except in Scandinavian countries [16]. Although its prevalence is not totally resolved, [10,17,18] it represents a rare syndrome, with an estimated 5 -50 cases per 10,000 [7].…”

Section: Demographymentioning

confidence: 99%

Pathophysiological mechanisms of Brugada syndrome: Depolarization disorder, repolarization disorder, or more?

Meregalli¹,

Wilde²,

Tan³

2005

Cardiovascular Research

332

266

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After its recognition as a distinct clinical entity, Brugada syndrome is increasingly recognized worldwide as an important cause of sudden cardiac death. Brugada syndrome exhibits autosomal dominant inheritance with SCN5A, which encodes the cardiac sodium channel, as the only gene with a proven involvement in 20-30% of patients. Its signature feature is ST segment elevation in right precordial ECG leads and predisposition to malignant ventricular tachyarrhythmias. The pathophysiological mechanism of ST elevation and ventricular tachyarrhythmia, two phenomena strongly related, is controversial. Here, we review clinical and experimental studies as they provide evidence to support or disprove the two hypotheses on the mechanism of Brugada syndrome that currently receive the widest support: (1) nonuniform abbreviation of right ventricular epicardial action potentials ("repolarization disorder"), (2) conduction delay in the right ventricular outflow tract ("depolarization disorder"). We also propose a schematic representation of the depolarization disorder hypothesis. Moreover, we review recent evidence to suggest that other derangements may also contribute to the pathophysiology of Brugada syndrome, in particular, right ventricular structural derangements. In reviewing these studies, we conclude that, similar to most diseases, it is likely that Brugada syndrome is not fully explained by one single mechanism. Rather than adhering to the notion that Brugada syndrome is a monofactorial disease, we should aim for clarification of the contribution of various pathophysiological mechanisms in individual Brugada syndrome patients and tailor therapy considering each of these mechanisms.

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“…In this present issue of the European Heart Journal, Junttila et al, 3 report a follow-up of 2479 healthy male Air Force applicants (18-30 years) and 542 healthy middleaged subjects (age 40-60). Fifteen (0.61%) subjects in the first population and three subjects in the second population (0.55%) fulfilled the ECG criteria for type 2 or 3 Brugada syndrome, according to the definition suggested by the European Society of Cardiology Consensus Report.…”

mentioning

confidence: 97%

Brugada sign: a normal variant or a bad omen? Insights for risk stratification and prognostication

Oto

2004

European Heart Journal

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This editorial refers to "Incidence, clinical implications and prognosis of atrial arrhythmias in Brugada Syndrome" by P. Bordachar et al. on page 879 and "Prevalence and prognosis of subjects with Brigada type ECG pattern in a young and middle-aged Finnish population" by M.J. Junttila et al. on page 874Brugada Syndrome is a relatively new clinical electro cardiographic entity with inordinate risk of sudden death in the absence of structural heart disease. However, the Brugada type of ECG changes have been known for almost half a century and observed in many asymptomatic individuals. 1 Recommendations for such individuals in the literature are rather conflicting. Although some authors use the term asymptomatic Brugada syndrome, the relationship between asymptomatic patients with typical ECG abnormalities and clinical cases of Brugada syndrome is not clear. Indeed, the Brugada pattern may also be provoked by right ventricular pathology, by drugs (e.g., Class I A, C anti-arrhythmic drugs, tri-cyclic antidepressants, overdose of psychotropic agents and analgesics that exhibit sodium channel blocking properties) and can be associated with electrolyte abnormalities (i.e., hyperkalaemia and hypercalcaemia). 2 In Brugada syndrome, affected individuals can usually be detected by the typical ECG pattern, although not all patients have such an ECG and can only be diagnosed by drug challenges with IV ajmaline, flecainide or procainamide.In a recent review, a systematic literature search was performed in order to identify publications on the Brugada syndrome and the Brugada sign with special emphasis on analysing the outcome data. 2 There have been two kinds of studies on the prognostic value and natural history of Brugada sign. In the first group of studies, the prevalence and outcome of the Brugada sign have been investigated in referred individuals. These patients were referred due to either a personal history of syncope or unexplained ventricular fibrillation, or a familial history of cardiac arrest, and the typical ECG pattern. In these studies the outcome appears to be unfavourable. In the second group, the studies have investigated the outcome of the presence of Brugada-type ECG changes in the general population. These studies have shown that the prevalence of Brugada ECG pattern varies between 0.2% and 6% and that in the general population the outcome is usually benign. The major limitation of those studies, however, is the relatively short duration before follow-up.In this present issue of the European Heart Journal, Junttila et al., 3 report a follow-up of 2479 healthy male Air Force applicants (18-30 years) and 542 healthy middleaged subjects (age 40-60). Fifteen (0.61%) subjects in the first population and three subjects in the second population (0.55%) fulfilled the ECG criteria for type 2 or 3 Brugada syndrome, according to the definition suggested by the European Society of Cardiology Consensus Report. 4 Type 1 Brugada abnormality was not detected. None of the subjects with the Brugada sign (saddleback type) d...

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Prevalence and prognosis of subjects with brugada-type ECG pattern in a young and middle-aged finnish population

Cited by 25 publications

References 0 publications

Prevalence and significance of Brugada-type ECG in 12,012 apparently healthy European subjects

Prevalence and significance of Brugada-type ECG in 12,012 apparently healthy European subjects

Pathophysiological mechanisms of Brugada syndrome: Depolarization disorder, repolarization disorder, or more?

Brugada sign: a normal variant or a bad omen? Insights for risk stratification and prognostication

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