Risk Stratification in Patients With Brugada Syndrome Without Previous Cardiac Arrest: Prognostic Value of Combined Risk Factors

Background:Risk stratification in patients with Brugada syndrome for primary prevention of sudden cardiac death is still an unsettled issue. A recent consensus statement suggested the indication of implantable cardioverter defibrillator (ICD) depending on the clinical risk factors present (spontaneo...

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Bibliographic Details
Published in:Circulation Journal 2015/01/23, Vol.79(2), pp.310-317
Main Authors: Okamura, Hideo, Kamakura, Tsukasa, Morita, Hiroshi, Tokioka, Koji, Nakajima, Ikutaro, Wada, Mitsuru, Ishibashi, Kohei, Miyamoto, Koji, Noda, Takashi, Aiba, Takeshi, Nishii, Nobuhiro, Nagase, Satoshi, Shimizu, Wataru, Yasuda, Satoshi, Ogawa, Hisao, Kamakura, Shiro, Ito, Hiroshi, Ohe, Tohru, Kusano, Kengo F.
Format: Article
Language:English
Subjects:
Adult
Brugada syndrome
Brugada Syndrome - complications
Brugada Syndrome - diagnosis
Brugada Syndrome - epidemiology
Brugada Syndrome - physiopathology
Electrocardiography
Electrophysiological study
Female
Follow-Up Studies
Heart Arrest
Humans
Male
Middle Aged
Primary prevention
Prognosis
Risk Assessment
Risk Factors
Risk stratification
Syncope
Syncope - diagnosis
Syncope - epidemiology
Syncope - etiology
Syncope - physiopathology
Ventricular Fibrillation - diagnosis
Ventricular Fibrillation - epidemiology
Ventricular Fibrillation - etiology
Ventricular Fibrillation - physiopathology
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Summary:Background:Risk stratification in patients with Brugada syndrome for primary prevention of sudden cardiac death is still an unsettled issue. A recent consensus statement suggested the indication of implantable cardioverter defibrillator (ICD) depending on the clinical risk factors present (spontaneous type 1 Brugada electrocardiogram (ECG) [Sp1], history of syncope [syncope], and ventricular fibrillation during programmed electrical stimulation [PES+]). The indication of ICD for the majority of patients, however, remains unclear.Methods and Results:A total of 218 consecutive patients (211 male; aged 46±13 years) with a type 1 Brugada ECG without a history of cardiac arrest who underwent evaluation for ICD including electrophysiological testing were examined retrospectively. During a mean follow-up period of 78 months, 26 patients (12%) developed arrhythmic events. On Kaplan-Meier analysis patients with each of Sp1, syncope, or PES+ suffered arrhythmic events more frequently (P=0.018, P
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-14-1059