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Eur Heart J. 2017 Jun 7;38(22):1756-1763. doi: 10.1093/eurheartj/ehx119.

A score model to predict risk of events in patients with Brugada Syndrome.

Author information

1
Heart Rhythm Management Centre, UZ Brussel-VUB, Laarbeeklaan 101, 1090, Brussels, Belgium.
2
Cardiac Surgery Department, UZ Brussel-VUB, Laarbeeklaan 101, 1090, Brussels, Belgium.

Abstract

Aims:

Risk stratification in Brugada Syndrome (BS) remains challenging. Arrhythmic events can occur life-long and studies with long follow-ups are sparse. The aim of our study was to investigate long-term prognosis and risk stratification of BS patients.

Methods and results:

A single centre consecutive cohort of 400 BS patients was included and analysed. Mean age was 41.1 years, 78 patients (19.5%) had a spontaneous type I electrocardiogram (ECG). Clinical presentation was aborted sudden cardiac death (SCD) in 20 patients (5.0%), syncope in 111 (27.8%) and asymptomatic in 269 (67.3%). Familial antecedents of SCD were found in 184 individuals (46.0%), in 31 (7.8%) occurred in first-degree relatives younger than 35 years. An implantable cardioverter defibrillator (ICD) was placed in 176 (44.0%). During a mean follow-up of 80.7 months, 34 arrhythmic events occurred (event rate: 1.4% year). Variables significantly associated to events were: presentation as aborted SCD (Hazard risk [HR] 20.0), syncope (HR 3.7), spontaneous type I (HR 2.7), male gender (HR 2.7), early SCD in first-degree relatives (HR 2.9), SND (HR 5.0), inducible VA (HR 4.7) and proband status (HR 2.1). A score including ECG pattern, early familial SCD antecedents, inducible electrophysiological study, presentation as syncope or as aborted SCD and SND had a predictive performance of 0.82. A score greater than 2 conferred a 5-year event probability of 9.2%.

Conclusions:

BS patients remain at risk many years after diagnosis. Early SCD in first-degree relatives and SND are risk factors for arrhythmic events. A simple risk score might help in the stratification and management of BS patients.

KEYWORDS:

Clinical characterization ; Prognosis ; Risk stratification ; Sudden cardiac death;  Brugada syndrome

PMID:
28379344
DOI:
10.1093/eurheartj/ehx119
[Indexed for MEDLINE]

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