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Does the Age of Sudden Cardiac Death in Family Members Matter in Brugada Syndrome?

Pattara Rattanawong1,2, Jakrin Kewcharoen3, Chanavuth Kanitsoraphan3

  • 1Department of Cardiovascular Medicine Mayo Clinic Phoenix AZ.

Journal of the American Heart Association
|May 20, 2021
PubMed

Insights

A family history of sudden cardiac death (SCD) in Brugada syndrome patients does not increase major arrhythmic event (MAE) risk overall. However, SCD in family members under 40 significantly elevates MAE risk.

Area of Science:

  • Cardiology
  • Genetics
  • Epidemiology

Background:

  • Brugada syndrome is an inherited cardiac channelopathy linked to major arrhythmic events (MAEs).
  • The role of a family history of sudden cardiac death (SCD) as a risk predictor for MAEs in Brugada syndrome patients is debated.
  • Identifying accurate risk predictors is crucial for managing Brugada syndrome and preventing life-threatening arrhythmias.

Purpose of the Study:

  • To systematically review and meta-analyze the association between family history of SCD and MAEs in Brugada syndrome.
  • To investigate if the age of SCD in family members modifies the risk of MAEs.
  • To provide evidence-based insights into risk stratification for Brugada syndrome patients.

Main Methods:

  • Systematic review and meta-analysis of studies published between January 1992 and January 2020.
  • Searched MEDLINE and EMBASE databases for relevant research.
  • Combined data using random-effects models and performed metaregression to assess age-related risk.

Main Results:

  • Twenty-two studies involving 3386 Brugada syndrome patients were included.
  • Overall family history of SCD was not significantly associated with increased MAE risk (OR, 1.11; P=0.489).
  • A history of SCD in family members younger than 40 years approximately doubled the risk of MAEs (OR, 2.03; P=0.022).

Conclusions:

  • A family history of SCD is not a universal risk factor for MAEs in Brugada syndrome.
  • However, SCD in younger family members (specifically under 40 years) is a significant risk factor for MAEs.
  • Age stratification of SCD in family history is critical for accurate risk assessment in Brugada syndrome.

Keywords:
Brugada syndromefamily historysudden cardiac death

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