Fever-related arrhythmic events in the multicenter Survey on Arrhythmic Events in Brugada Syndrome

Abstract

The risk of fever-related AE in BrS markedly varies according to age group, sex, and ethnicity. Taking these factors into account could help the clinical management of patients with BrS with fever.

Repetitive syncopal episodes in a child with documented ventricular tachycardia, early repolarization pattern in leads I an aVL, Brugada syndrome, and fever

“…The BrS ECG is much more prevalent in patients with fever than in afebrile controls with a high F I G U R E 4 Twelve lead Holter monitoring during febrile peak (38°C), note J-wave elevation in leads I and aVL and the presence of an alternant Brugada pattern in V2 prevalence in children aged 0-5 years (Adler et al, 2013). Although the risk of fever-related AE in BrS markedly varies according to age group, sex, and ethnicity, with a high prevalence of fever and AEs in the Caucasian population, where there is a high proportion of patients with an SCN5A mutation (77%) (Michowitz et al, 2018).…”

“…The BrS ECG is much more prevalent in patients with fever than in afebrile controls with a high prevalence in children aged 0–5 years (Adler et al, ). Although the risk of fever‐related AE in BrS markedly varies according to age group, sex, and ethnicity, with a high prevalence of fever and AEs in the Caucasian population, where there is a high proportion of patients with an SCN5A mutation (77%) (Michowitz et al, ). The principal mechanism of AEs during fever is the worsening of the biophysical properties of the defective ion channels at higher temperatures, leading to further loss of function of the sodium channel current (Dumaine et al, ).…”

“…(SABRUS) data, in only 4.3% the first AE occurs in the pediatric population (Milman et al, 2017). The Brugada syndrome ECG is much more prevalent in patients with fever than in afebrile controls (Michowitz et al, 2018). We present a small child with febrile peaks and syncopal episodes, in whom it was eventually possible to demonstrate the Brugada syndrome with a special presentation in the ECG: early repolarization pattern in leads I and aVL and Brugada pattern during fever in V1-V2.…”

“…According to the Survey on Arrhythmic Events in Brugada Syndrome (SABRUS) data, in only 4.3% the first AE occurs in the pediatric population (Milman et al, ). The Brugada syndrome ECG is much more prevalent in patients with fever than in afebrile controls (Michowitz et al, ).…”

Man with fever, cough and atypical chest pain

“…1 Several factors such as certain drugs, increase in vagal tone, and fever can unmask the type 1 Brugada ECG pattern. 2 Our patient's presentation to hospital with COVID-19 pneumonia allowed for opportunistic diagnosis of an asymptomatic type 1 Brugada ECG pattern, and he has since been advised on avoiding specific medications, excessive exercise, and reducing fever. 3…”