Long-Term Prognosis of Individuals With Right Precordial ST-Segment–Elevation Brugada Syndrome

• Lars Eckardt

  From the Westfälische Wilhelms University Hospital, Department of Cardiology and Angiology, Münster, Germany (L.E., E.S.B., T.W., G.B., D.B.); University Hospital, Department of Cardiology, Nantes, France (V.P., H.L.); INSERM U533, University of Nantes, Nantes, France (V.P., P.B., H.L.); Experimental and Molecular Cardiology Group, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.P.P.S., A.A.M.W.); University Hospital Mannheim, University of Heidelberg, Mannheim,...

• Vincent Probst

  From the Westfälische Wilhelms University Hospital, Department of Cardiology and Angiology, Münster, Germany (L.E., E.S.B., T.W., G.B., D.B.); University Hospital, Department of Cardiology, Nantes, France (V.P., H.L.); INSERM U533, University of Nantes, Nantes, France (V.P., P.B., H.L.); Experimental and Molecular Cardiology Group, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.P.P.S., A.A.M.W.); University Hospital Mannheim, University of Heidelberg, Mannheim,...

• Jeroen P.P. Smits

  From the Westfälische Wilhelms University Hospital, Department of Cardiology and Angiology, Münster, Germany (L.E., E.S.B., T.W., G.B., D.B.); University Hospital, Department of Cardiology, Nantes, France (V.P., H.L.); INSERM U533, University of Nantes, Nantes, France (V.P., P.B., H.L.); Experimental and Molecular Cardiology Group, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.P.P.S., A.A.M.W.); University Hospital Mannheim, University of Heidelberg, Mannheim,...

• Eric Schulze Bahr

  From the Westfälische Wilhelms University Hospital, Department of Cardiology and Angiology, Münster, Germany (L.E., E.S.B., T.W., G.B., D.B.); University Hospital, Department of Cardiology, Nantes, France (V.P., H.L.); INSERM U533, University of Nantes, Nantes, France (V.P., P.B., H.L.); Experimental and Molecular Cardiology Group, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.P.P.S., A.A.M.W.); University Hospital Mannheim, University of Heidelberg, Mannheim,...

• Christian Wolpert

  From the Westfälische Wilhelms University Hospital, Department of Cardiology and Angiology, Münster, Germany (L.E., E.S.B., T.W., G.B., D.B.); University Hospital, Department of Cardiology, Nantes, France (V.P., H.L.); INSERM U533, University of Nantes, Nantes, France (V.P., P.B., H.L.); Experimental and Molecular Cardiology Group, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.P.P.S., A.A.M.W.); University Hospital Mannheim, University of Heidelberg, Mannheim,...

• Rainer Schimpf

  From the Westfälische Wilhelms University Hospital, Department of Cardiology and Angiology, Münster, Germany (L.E., E.S.B., T.W., G.B., D.B.); University Hospital, Department of Cardiology, Nantes, France (V.P., H.L.); INSERM U533, University of Nantes, Nantes, France (V.P., P.B., H.L.); Experimental and Molecular Cardiology Group, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.P.P.S., A.A.M.W.); University Hospital Mannheim, University of Heidelberg, Mannheim,...

• Thomas Wichter

  From the Westfälische Wilhelms University Hospital, Department of Cardiology and Angiology, Münster, Germany (L.E., E.S.B., T.W., G.B., D.B.); University Hospital, Department of Cardiology, Nantes, France (V.P., H.L.); INSERM U533, University of Nantes, Nantes, France (V.P., P.B., H.L.); Experimental and Molecular Cardiology Group, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.P.P.S., A.A.M.W.); University Hospital Mannheim, University of Heidelberg, Mannheim,...

• Pierre Boisseau

  From the Westfälische Wilhelms University Hospital, Department of Cardiology and Angiology, Münster, Germany (L.E., E.S.B., T.W., G.B., D.B.); University Hospital, Department of Cardiology, Nantes, France (V.P., H.L.); INSERM U533, University of Nantes, Nantes, France (V.P., P.B., H.L.); Experimental and Molecular Cardiology Group, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.P.P.S., A.A.M.W.); University Hospital Mannheim, University of Heidelberg, Mannheim,...

• Achim Heinecke

  From the Westfälische Wilhelms University Hospital, Department of Cardiology and Angiology, Münster, Germany (L.E., E.S.B., T.W., G.B., D.B.); University Hospital, Department of Cardiology, Nantes, France (V.P., H.L.); INSERM U533, University of Nantes, Nantes, France (V.P., P.B., H.L.); Experimental and Molecular Cardiology Group, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.P.P.S., A.A.M.W.); University Hospital Mannheim, University of Heidelberg, Mannheim,...

• Günter Breithardt

  From the Westfälische Wilhelms University Hospital, Department of Cardiology and Angiology, Münster, Germany (L.E., E.S.B., T.W., G.B., D.B.); University Hospital, Department of Cardiology, Nantes, France (V.P., H.L.); INSERM U533, University of Nantes, Nantes, France (V.P., P.B., H.L.); Experimental and Molecular Cardiology Group, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.P.P.S., A.A.M.W.); University Hospital Mannheim, University of Heidelberg, Mannheim,...

• Martin Borggrefe

  From the Westfälische Wilhelms University Hospital, Department of Cardiology and Angiology, Münster, Germany (L.E., E.S.B., T.W., G.B., D.B.); University Hospital, Department of Cardiology, Nantes, France (V.P., H.L.); INSERM U533, University of Nantes, Nantes, France (V.P., P.B., H.L.); Experimental and Molecular Cardiology Group, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.P.P.S., A.A.M.W.); University Hospital Mannheim, University of Heidelberg, Mannheim,...

• Herve LeMarec

  From the Westfälische Wilhelms University Hospital, Department of Cardiology and Angiology, Münster, Germany (L.E., E.S.B., T.W., G.B., D.B.); University Hospital, Department of Cardiology, Nantes, France (V.P., H.L.); INSERM U533, University of Nantes, Nantes, France (V.P., P.B., H.L.); Experimental and Molecular Cardiology Group, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.P.P.S., A.A.M.W.); University Hospital Mannheim, University of Heidelberg, Mannheim,...

• Dirk Böcker

  From the Westfälische Wilhelms University Hospital, Department of Cardiology and Angiology, Münster, Germany (L.E., E.S.B., T.W., G.B., D.B.); University Hospital, Department of Cardiology, Nantes, France (V.P., H.L.); INSERM U533, University of Nantes, Nantes, France (V.P., P.B., H.L.); Experimental and Molecular Cardiology Group, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.P.P.S., A.A.M.W.); University Hospital Mannheim, University of Heidelberg, Mannheim,...

• Arthur A.M. Wilde

  From the Westfälische Wilhelms University Hospital, Department of Cardiology and Angiology, Münster, Germany (L.E., E.S.B., T.W., G.B., D.B.); University Hospital, Department of Cardiology, Nantes, France (V.P., H.L.); INSERM U533, University of Nantes, Nantes, France (V.P., P.B., H.L.); Experimental and Molecular Cardiology Group, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands (J.P.P.S., A.A.M.W.); University Hospital Mannheim, University of Heidelberg, Mannheim,...

Abstract

Background— Brugada syndrome is an arrhythmogenic disease characterized by an ECG pattern of ST-segment elevation in the right precordial leads and an increased risk of sudden cardiac death as a result of ventricular fibrillation. Controversy exists with regard to risk stratification and therapeutic management, particularly in asymptomatic individuals. Methods and Results— A total of 212 individuals (mean age, 45±6 years) with a type 1 Brugada ECG pattern were studied. Of these, 123 (58%) were asymptomatic, 65 (31%) had ≥1 syncope of unknown origin, and 24 (11%) had to be resuscitated because of ventricular fibrillation. In 125 individuals (59%), a spontaneous type 1 ECG was recorded. In the remaining, drug challenge with a class I antiarrhythmic agent unmasked a Brugada ECG. The mean ST elevation was 2.3±1.2 mm in symptomatic patients and 1.9±1.5 mm in asymptomatic individuals ( P =0.04). During a mean follow-up of 40±50 months, 4 of the 24 patients (17%) with aborted sudden cardiac death and 4 of 65 (6%) with a prior syncope had a recurrent arrhythmic event, whereas only 1 of 123 asymptomatic individuals (0.8%) had a first arrhythmic event. Four of 9 patients with arrhythmic events during follow-up were not inducible during programmed electrical stimulation. A previous history of aborted sudden death or syncope and the presence of a spontaneous type 1 ECG were predictors of adverse outcome. Conclusions— The present study reports data on a large population of individuals with a type 1 Brugada ECG pattern with the longest follow-up reported so far. A very low incidence of severe arrhythmic events, particularly in asymptomatic individuals, was found during follow-up. In the presence of very few arrhythmic events on follow-up, programmed electrical stimulation showed very little accuracy in predicting outcome.

Journal

• Circulation

  Circulation 111 (3), 257-263, 2005-01-25

  Ovid Technologies (Wolters Kluwer Health)

Keywords

• Physiology (medical)
• Cardiology and Cardiovascular Medicine

Details

• CRID: 1364233269948575488
• NII Article ID: 30022672023
• DOI: 10.1161/01.cir.0000153267.21278.8d
• ISSN: 15244539
• ISSN: 00097322
• Web Site: https://www.ahajournals.org/doi/full/10.1161/01.CIR.0000153267.21278.8D
• Data Source:
  • Crossref
  • CiNii Articles