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Brugada syndrome in Japan
1Department of Cardiovascular Diseases, Tokyo Medical and Dental University, Minato-ku, Tokyo 105-0011, Japan. hiraoka-masayasu@mhlw.go.jp
Summary
Brugada syndrome (BS) is more common in Japan, affecting 0.1-0.2% of people, particularly middle-aged men. Risk factors for cardiac events in BS patients require careful evaluation for effective management.
Area of Science:
- Cardiology
- Genetics
- Epidemiology
Background:
- Brugada syndrome (BS) exhibits a higher incidence in Japan (0.1-0.2%) compared to global prevalence.
- The condition predominantly affects middle-aged men and is characterized by specific ECG changes and a high recurrence rate in symptomatic individuals.
Purpose of the Study:
- To analyze the epidemiological characteristics and risk factors associated with Brugada syndrome in Japan.
- To identify key determinants for risk stratification in patients with Brugada syndrome.
Main Methods:
- Review of epidemiological data on Brugada syndrome incidence in Japan.
- Analysis of clinical presentation, ECG findings, and genetic mutations (SCN5A) in Japanese BS patients.
- Evaluation of factors contributing to cardiac events and recurrence in both symptomatic and asymptomatic individuals.
Main Results:
- Japanese BS population shows a relatively low incidence of SCN5A mutations despite high prevalence.
- Asymptomatic patients in Japan have a lower rate of cardiac events compared to other countries.
- Increased vagal tone and/or decreased sympathetic activity are implicated as potential triggers for cardiac events.
Conclusions:
- Risk stratification for life-threatening arrhythmias in Brugada syndrome necessitates evaluating multiple factors, including Type 1 ECG, family history, inducible arrhythmias, and late potentials.
- An implantable cardioverter defibrillator is recommended for patients who have experienced aborted sudden cardiac death.
- Further research into the unique characteristics of BS in Japan may offer insights into disease mechanisms and management.
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