BRUGADA ECG PATTERN AND CARDIAC ARREST. LESSONS FROM RETROSPECTIVE STUDIES
P. Delise, G. Allocca, N. Sitta, L. Sciarra, F. Migliore, D. Corrado, L. Calo', V. Carinci, F. Dagradi, P. Schwartz
Cardiology Department, Casa di Cura Pederzoli, Peschiera del Garda, Italy
Aims: The identification of patients with the Brugada type 1 ecg pattern (Br-type 1) at risk of sudden death (SD) dibated issue.
Methods: We made a cumulative analysis of 19 large studies including patients with Br type 1and previous aborted SD (aSD) (Group A). In addition we assessed the characteristics of patients with SD who had a familial Br-type 1 (Group B).
Results: Group A included 382 cases. 96% were males, 69% had nocturnal aSD and 40% had a drug-induced Br-type 1. Group B included 71 patients with SD belonging to 65 families. In 9 of them an ecg recorded before SD. In 3/9 a Br-type 1 was present.
Conclusions: 1) Data from retrospective studies are in contrast with those coming from prospective studies, particularly about the risk of drug-induced Br-type 1; 2) Patients with CA belonging to families with Br-type 1, frequently have not a Br- type 1; 3) In patients with CA classified as having Brugada syndrome on the basis of a retrospective evaluation, the Br-type 1 might be a concomitant defect and not the only cause.
Retrospective analysis of patients with Brugada type 1 pattern and aborted SD. Cumulative data from published studies and personal unpublished data
total |
Published studies |
personal data |
Unpublished |
|
|
|
P |
| N | % | N | % | | N | % |
Cases | 366 | 100% | 16 | 100% | | 382 | 100% |
Males | 277/286 | 97% | 13/16 | 81% | 0.0012 | 290/302 | 96% |
Age (mean) | 45+/-11 | 40+/-11 | | 0.71 | | 44+/-11 |
Nocturnal SD | 55/71 | 77% | 5/16 | 31% | 0.0003 | 60/87 | 69% |
Previous syncope | 30/77 | 39% | 6/16 | 37% | 0.8812 | 36/93 | 39% |
Spontaneous type 1
-All
-2010-2014
|
254/326
91/146
|
78%
62%
|
7/16*
|
44%
|
0.1626
|
98/162
|
60%
|
Familial SD | 59/286 | 21% | 4/16 | 25% | 0.7033 | 63/302 | 21% |
+EPS/EPS | 189/269 | 70% | 4/4 | 100% | 0.1918 | 193/273 | 71% |
f-QRS | 33/63 | 52% | 0/9 | 0% | 0.0034 | 33/72 | 46% |
ER | 15/89 | 17% | 2/9 | 22% | 0.7065 | 17/98 | 17% |
SCN5A | 14/56 | 25% | 2/5 | 40% | 0.4650 | 16/61 | 21% |