Risk stratification of the patients with Brugada type electrocardiogram: a community-based prospective study

Giustetto, Carla; Drago, Stefano; Demarchi, Pier Giuseppe; Dalmasso, Paola; Bianchi, Francesca; Masi, Andrea Sibona; Carvalho, Pedro Boal; Occhetta, Eraldo; Rossetti, Guido; Riccardi, Riccardo; Bertona, Roberta; Gaïta, Fiorenzo; Section, Cardiostimulation -Piedmont

doi:10.1093/europace/eup006

Cited by 107 publications

(67 citation statements)

References 23 publications

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“…This international registry also contains follow-up data on patients included in a previous study published in 2005 and recently reported Italian patients. 2,8 From the present study comprising 1029 patients, 212 patients were initially described in Circulation in 2005. 2 The follow-up of this population was 40Ϯ50 months.…”

Section: Methodsmentioning

confidence: 99%

“…The Italian group included 192 patients in the registry; of them, 166 have also been described in Europace. 8 Finally, 378 of the 1029 patients have already been included in a publication, which means that 657 patients are new. We can consider that over a total follow-up of 1029ϫ37ϭ38 073 months, the patients from the Eckardt publication represent 212ϫ40ϭ8480 months of follow-up, and the patients from the Europace publication from the Italian group represent 166ϫ30ϭ4980 months, for a total of 13 460 months.…”

Section: Methodsmentioning

confidence: 99%

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Long-Term Prognosis of Patients Diagnosed With Brugada Syndrome

et al. 2010

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Background-Brugada syndrome is characterized by ST-segment elevation in the right precordial leads and an increased risk of sudden cardiac death (SCD). Fundamental questions remain on the best strategy for assessing the real disease-associated arrhythmic risk, especially in asymptomatic patients. The aim of the present study was to evaluate the prognosis and risk factors of SCD in Brugada syndrome patients in the FINGER (France, Italy, Netherlands, Germany) Brugada syndrome registry. Methods and Results-Patients were recruited in 11 tertiary centers in 4 European countries. Inclusion criteria consisted of a type 1 ECG present either at baseline or after drug challenge, after exclusion of diseases that mimic Brugada syndrome. The registry included 1029 consecutive individuals (745 men; 72%) with a median age of 45 (35 to 55) years. Diagnosis was based on (1) aborted SCD (6%); (2) syncope, otherwise unexplained (30%); and (3) asymptomatic patients (64%). During a median follow-up of 31.9 (14 to 54.4) months, 51 cardiac events (5%) occurred (44 patients experienced appropriate implantable cardioverter-defibrillator shocks, and 7 died suddenly). The cardiac event rate per year was 7.7% in patients with aborted SCD, 1.9% in patients with syncope, and 0.5% in asymptomatic patients. Symptoms and spontaneous type 1 ECG were predictors of arrhythmic events, whereas gender, familial history of SCD, inducibility of ventricular tachyarrhythmias during electrophysiological study, and the presence of an SCN5A mutation were not predictive of arrhythmic events. Conclusions-In the largest series of Brugada syndrome patients thus far, event rates in asymptomatic patients were low.Inducibility of ventricular tachyarrhythmia and family history of SCD were not predictors of cardiac events. (Circulation. 2010;121:635-643.)

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Long-Term Prognosis of Patients Diagnosed With Brugada Syndrome

et al. 2010

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“…Figure 4 shows the outcome data in the various studies in which the predictive value of electrophysiological study was tested in asymptomatic patients with a spontaneous type 1 ECG or a drug-induced ECG. 105,106,110,111,[116][117][118][119][120][121][122][123] Indeed, the initial drop in follow-up events in the studies published by Brugada et al 110,116 can only be explained by the inclusion of patients with a more-severe condition. In the more-recent studies, the event rate during a follow-up period of 3 to 4 years is between 0% and 5%, the latter still including the patients already included in the first series published by Brugada et al 123 It is not clear why the results diverge, but the differences in electrophysiology study protocol may be critical.…”

Section: Insight Into Brugada Syndrome An Updatementioning

confidence: 99%

Brugada Syndrome

Mizusawa

Wilde

2012

Circ: Arrhythmia and Electrophysiology

239

245

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“…The predictive value of EPS in stratifying these patients was also demonstrated by Giustetto et al, who prospectively studied the incidence of arrhythmic events in 166 patients with type 1 Brugada ECG pattern and found that the only predictors were syncope, aborted sudden death and positive EPS. 7 However, according to Priori et al, VT or VF inducibility on EPS did not predict malignant arrhythmias or sudden death, 8 and along the same lines, Gehi et al concluded that EPS did not add relevant information for the management of patients with Brugada syndrome. 9 Furthermore, multivariate analysis of the largest registry of Brugada patients, the FINGER Brugada Syndrome Registry, showed that EPS results were not predictive of time to first arrhythmic event.…”

Section: Discussionmentioning

confidence: 99%

Syncope and intermittent Brugada ECG pattern

Picarra

Cunha

Oliveira

et al. 2013

Revista Portuguesa de Cardiologia (English Edition)

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Brugada syndrome is a rare syndrome, with an estimated prevalence in Europe of 1---5/10 000 population, whose initial clinical presentation can be sudden death. Although it has a characteristic electrocardiographic pattern, this can be intermittent. The authors present the case of a 32-year-old man, with no family history of syncope or sudden death, who went to the emergency department for syncope without prodromes. The initial electrocardiogram (ECG) in sinus rhythm documented an isolated and non-specific ST-segment elevation in V2. During further diagnostic studies, a repeat ECG revealed type 1 Brugada pattern. This pattern was later seen in a more marked form during a respiratory infection. The patient subsequently underwent electrophysiological study, followed by implantation of an implantable cardioverterdefibrillator (ICD), with an episode of ventricular fibrillation converted via ICD shock two months after implantation. © 2011 Sociedade Portuguesa de Cardiologia. Published by Elsevier España, S.L. All rights reserved. PALAVRAS-CHAVESíndrome de Brugada; Estudo eletrofisiológico; Cardioversordesfibrilhador implantável Síncope e padrão de Brugada intermitenteResumo A síndrome de Brugada é uma síndrome rara, com uma prevalência aproximada na Europa de 1-5/10 000 habitantes, mas cuja apresentação clínica inicial pode ser morte súbita. Embora com um padrão eletrocardiográfico típico, este é por vezes intermitente. Os autores apresentam o caso clínico de um doente de sexo masculino, de 32 anos, sem fatores de risco pessoais conhecidos e história familiar de morte súbita, que recorre ao Serviço de Urgência por síncope sem pródromos. O primeiro eletrocardiograma (ECG) em ritmo sinusal documenta a presença de uma elevação isolada e inespecífica do segmento ST em V2. Da restante investigação diagnóstica realizada, salienta-se a repetição do ECG, que revelou a presença de padrão de Brugada tipo 1. Este mesmo padrão é exacerbado posteriormente numa situação de infeção respiratória. O doente foi submetido a estudo eletrofisiológico, seguido de implantação de

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Risk stratification of the patients with Brugada type electrocardiogram: a community-based prospective study

Abstract: Clinical presentation is the most important parameter in the risk stratification of patients with Brugada ECG. Programmed electrical stimulation seems valuable, particularly in patients with previous syncope.

Cited by 107 publications

References 23 publications

Long-Term Prognosis of Patients Diagnosed With Brugada Syndrome

Long-Term Prognosis of Patients Diagnosed With Brugada Syndrome

Brugada Syndrome

Syncope and intermittent Brugada ECG pattern

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