Document Detail


Risk stratification of the patients with Brugada type electrocardiogram: a community-based prospective study.
MedLine Citation:
PMID:  19193676     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Risk stratification of patients with Brugada electrocardiogram (ECG) is being strongly debated. Conflicting results have been suggested from international registries, which enrolled non-consecutive cases, studied with different programmed electrical stimulation (PES) protocols. The aim of this study was to prospectively evaluate the incidence of arrhythmic events and the prognostic role of clinical presentation, ECG, and of a standardized PES protocol in consecutive cases from a community-based population. METHODS AND RESULTS: A total of 166 consecutive patients (45 +/- 14 years) with Brugada ECG were enrolled. Type 1 ECG was observed spontaneously in 72 (43%) and after pharmacological testing in 94 (57%). One hundred and three (62%) were asymptomatic, 58 (35%) had syncope, and five (3%) had a prior cardiac arrest. One hundred and thirty-five (81%) underwent PES with two extra stimuli up to ventricular refractoriness and 34% had ventricular fibrillation (VF) induced. Arrhythmic events occurred in nine patients at a mean follow-up of 30 +/- 21 months (2.2 events per 100 person-year): in three (60%) patients with aborted sudden death (aSD), five (8.6%) of those with syncope, and one (1%) of the asymptomatic. The only predictors of events were a history of syncope or aSD (P = 0.02) and induction at PES (P = 0.004). CONCLUSION: Clinical presentation is the most important parameter in the risk stratification of patients with Brugada ECG. Programmed electrical stimulation seems valuable, particularly in patients with previous syncope.
Authors:
Carla Giustetto; Stefano Drago; Pier Giuseppe Demarchi; Paola Dalmasso; Francesca Bianchi; Andrea Sibona Masi; Paula Carvalho; Eraldo Occhetta; Guido Rossetti; Riccardo Riccardi; Roberta Bertona; Fiorenzo Gaita;
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Publication Detail:
Type:  Journal Article     Date:  2009-02-04
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  11     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-24     Completed Date:  2009-06-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  507-13     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Cardinal Massaia Hospital, University of Torino, Corso Dante, 202, 14100 Asti, Italy. carlagiustetto@mac.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Arrhythmias, Cardiac / etiology,  physiopathology
Brugada Syndrome / complications*,  genetics,  therapy*
Child
Death, Sudden, Cardiac / epidemiology*
Defibrillators, Implantable*
Electrocardiography
Female
Follow-Up Studies
Humans
Italy
Kaplan-Meiers Estimate
Male
Middle Aged
Prospective Studies
Risk Factors
Severity of Illness Index
Syncope / etiology,  physiopathology
Treatment Outcome
Young Adult
Investigator
Investigator/Affiliation:
Antonino Previti / ; Lorella Barbonaglia / ; Anna Ferraro / ; Miriam Bortnik / ; Piergiorgio Golzio / ; Marcella Jorfida / ; Claudio Bruna / ; Cosimo Tolardo / ; Luisella Coda / ; Antonio Visconti /
Comments/Corrections
Comment In:
Europace. 2009 Apr;11(4):412-3   [PMID:  19244257 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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