Brugada syndrome in the young: an assessment of risk factors predicting future events

Abstract

Symptomatic BS in the young age is a rare but malignant condition that can manifest with a spectrum of electrical abnormalities (i.e. SND, atrial tachycardias, AV block, and infra-nodal conduction delay) and result in the extreme cases in lethal arrhythmic events and SCD.

Association between PR Interval, First‐degree atrioventricular block and major arrhythmic events in patients with Brugada syndrome – Systematic review and meta‐analysis

“…Five studies reported the mean ± SD of PR interval in groups with and without major arrhythmic events. Corcia et al (2 studies) and Morita et al showed a longer PR interval in patients with major arrhythmic events . Juntilla et al, Ohkubo et al, and Corcia et al demonstrated that although the mean PR interval seemed to be higher, there was no significant difference in mean PR interval in Brugada syndrome patients with or without major arrhythmic events .…”

“…We included 7 studies (6 cohorts and 1 case‐control) for qualitative synthesis (Table ), and 7 studies were available for meta‐analysis. We included 1526 subjects from 7 studies …”

“…Three studies reported the association between first‐degree AV and the major arrhythmic outcome. Corcia et al reported an odds ratio (OR) of 3.42 95% CI (1.53‐7.64); P = 0.003 . Maury et al reported OR of 2.61 (1.16‐5.85); P = 0.02 .…”

“…Six studies are cohort, and 1 study is a case‐control, hence the latter study by Juntilla et al did not include the patient's follow‐up . Prevalence of first‐degree AVB is highest in Maury et al (35%) then Corcia et al (30.5% and 17%), Migliore et al (16.5%), and Morita et al (14.64%) . The limitation of the studies was that most of the studies also assessed those who undergone provocative testing using sodium‐channel blocker which may cause prolongation of the PR interval.…”

Brugada syndrome: new concepts and algorithms in management (RCD code: V 1A.1)

“…Other ECG abnormalities such as QRS fragmentation, prolonged QRS duration, T peak-T end interval (transmural dispersion of repolarization), presence of wide S wave in lead I, and prominent R wave in aVR are associated with an elevated risk of arrhythmias [20,21]. Moreover, in a prospective cohort study of young patients with BrS, it was shown that the presence of first degree atrioventricular block (AVB), atrial arrhythmias, sick sinus node disease, and spontaneous type 1 BrS ECG pattern were indicators of future ventricular arrhythmias [22]. Taking into account the high incidence of different cardiac rhythm abnormalities in BrS, including atrial fibrillation, the most common atrial arrhythmia in BrS (incidence ranging from 6% to 53%), active screening and timely introduction of proper management is appropriate in this group of patients [23][24][25].…”