Tuesday, September 08, 2015

What is the prognosis for patients with an asymptomatic type 1 Brugada pattern?

From a recentstudy:

Methods and Results—Patients presenting with spontaneous or drug-induced Brugada type I electrocardiogram (ECG) and no symptoms at our institution were considered eligible. A total of 363 consecutive patients (200 males, 55.1%; mean age: 40.9±17.2 years, 41 (11.3%) with spontaneous type I ECG) were included. Electrophysiological study (EPS) was performed in 321 (88.4%) and ventricular arrhythmias (VA) were induced in 32 (10%). An implantable cardioverter defibrillator (ICD) was implanted in 61 (16.8%). After a mean follow-up time of 73.2±58.9 months, 9 arrhythmic events occurred, accounting for an annual incidence rate of 0.5%. Event free survival was 99.0% at 1 year and 96.2% at 5 years, 95.4% at 10 and 15 years. Univariate analysis identified as risk factors EPS inducibility (HR 11.4, p less than 0.01), spontaneous type I (HR 4.0, p=0.04) and previous sinus node dysfunction (SND) (HR 8.0, 95% CI 1.0 - 63.9, p=0.05). At the multivariate analysis only inducibility remained significant (HR 9.1, p less than 0.01)

Conclusions—Arrhythmic events in asymptomatic BS patients are not insignificant. VA inducibility, spontaneous type I ECG and presence of SND might be considered as risk factors and used to drive long term management.

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