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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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Long-term prognosis of probands with Brugada-pattern ST-elevation in leads V1-V3

Shiro Kamakura1, Tohru Ohe, Kiyoshi Nakazawa

  • 1Division of Cardiology, National Cardiovascular Center, Suita, Osaka 565-8565, Japan. kamakura@hsp.ncvc.go.jp

Circulation. Arrhythmia and Electrophysiology
|October 22, 2009
PubMed

Insights

Patients with Brugada syndrome and non-type 1 ECG have a similar prognosis to those with type 1 ECG. Family history of sudden cardiac death and early repolarization predict poor outcomes in Brugada syndrome patients.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Genetics

Background:

  • Brugada syndrome is a rare genetic disorder that affects the heart's electrical system.
  • ST-elevation patterns on an electrocardiogram (ECG) are used to diagnose Brugada syndrome.
  • The prognostic significance of non-type 1 (saddleback) ST-elevation in Brugada syndrome remains unclear.

Purpose of the Study:

  • To determine the long-term prognosis of patients with Brugada syndrome presenting with non-type 1 ECG.
  • To compare the prognosis of patients with non-type 1 ECG to those with the more common type 1 (coved) Brugada-pattern ECG.

Main Methods:

  • A prospective study followed 330 probands with Brugada-pattern ECG (type 1 or non-type 1).
  • ECG patterns were confirmed using drug provocation tests and multiple recordings.
  • Patients were followed for an average of 48.7 months to assess arrhythmic events and syncope.

Main Results:

  • The long-term prognosis for patients with non-type 1 ECG was similar to that of patients with type 1 ECG.
  • The annual arrhythmic event rate for ventricular fibrillation was 10.2% for type 1 and 10.6% for non-type 1.
  • Family history of sudden cardiac death before age 45 and inferolateral early repolarization were independent predictors of fatal arrhythmic events.

Conclusions:

  • The type of ST-elevation pattern (type 1 vs. non-type 1) does not significantly alter the long-term prognosis in Brugada syndrome.
  • Family history of sudden cardiac death and early repolarization are critical indicators of poor prognosis in Brugada syndrome.
  • Spontaneous type 1 ECG and inducibility of ventricular fibrillation during electrophysiological studies were not reliable prognostic markers.
Abstract

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