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Paroxysmal, Persistent, and Permanent Type-1 Brugada Pattern: Does Burden Matter?
Thanaboon Yinadsawaphan1,2, Pattara Rattanawong1,3, Narathorn Kulthamrongsri1,2
1Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ 85054, USA.
Insights
The burden of spontaneous type-1 Brugada patterns, identified on electrocardiograms (ECGs), may correlate with major arrhythmic event risk. Higher pattern persistence suggests a potentially elevated risk for these cardiac events.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Spontaneous type-1 Brugada patterns indicate elevated risk for major arrhythmic events.
- The association between the degree of Brugada pattern burden and the risk of a first major arrhythmic event is not well-defined.
Purpose of the Study:
- To investigate the relationship between the burden of spontaneous type-1 Brugada patterns and the risk of experiencing a first major arrhythmic event.
Main Methods:
- Retrospective cohort study of 64 adult patients with spontaneous type-1 Brugada patterns.
- Patients underwent serial 12-lead electrocardiograms (ECGs) for pattern quantification.
- Pattern burden categorized as paroxysmal (<50%), persistent (50-99%), or permanent (100%).
- Median follow-up of 92 months, excluding patients with prior events.
Main Results:
- Seven patients (11%) experienced their first major arrhythmic event.
- Events occurred in one paroxysmal, four persistent, and two permanent pattern groups.
- Hazard ratios indicated a trend towards increased risk with higher pattern burden, though not statistically significant.
- No sudden cardiac deaths were observed.
Conclusions:
- A higher burden of spontaneous type-1 Brugada patterns may be associated with an increased risk of major arrhythmic events.
- Further research is warranted to clarify the prognostic significance of varying Brugada pattern burdens.
Abstract:
Spontaneous type-1 Brugada patterns are associated with an elevated risk of major arrhythmic events, yet the relationship between varying degrees of pattern burden and the occurrence of a first major arrhythmic event remains unclear. This retrospective cohort study included 64 adult patients with a spontaneous type-1 Brugada pattern, who were identified at Mayo Clinic sites and followed for ≥12 months after the initial diagnosis. All patients underwent at least three 12-lead electrocardiograms (ECGs) within the first year. Individuals with prior major arrhythmic events were excluded. The percentage of ECGs showing a type-1 pattern was calculated and categorized as paroxysmal (<50%), persistent (50-99%), or permanent (100%). During a median follow-up of 92 months, seven patients (11%) experienced their first major arrhythmic event. Of these, one had paroxysmal, four had persistent, and two had permanent spontaneous type-1 Brugada patterns. Although statistical significance was not reached, the hazard ratios suggested a trend toward increased risk with persistent and permanent patterns compared to paroxysmal patterns. No sudden cardiac deaths occurred during follow-up. These findings suggest that a higher burden of spontaneous type-1 Brugada patterns may be associated with increased arrhythmic risk.
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