Long-Term Trends in Newly Diagnosed Brugada Syndrome

Abstract

Since being first described, the presentation of BrS has changed. There has been a decrease in aborted sudden cardiac death as the first manifestation of the disease among patients who were more recently diagnosed. These variations in initial presentation have important clinical consequences. In this setting, the value of inducibility to stratify individuals with BrS has changed.

The Brugada Syndrome ― From Gene to Therapy ―

“…It is important to remark that ICDs are not free from several disadvantages, especially in young patients who will undergo plural device replacements for battery exhaustion. 62 To this regard, at 10-years postimplantation, the rates of inappropriate shocks and/or device malfunction caused by lead failure are 37% and 29%, respectively. 63 Endocardial lead dysfunction requires extraction and replacement, with further complications.…”

Brugada syndrome: current diagnostics, epidemiology, genetic data and novel mechanisms (RCD code: V-1A.1)

“…The trends in incidence of spontaneous type 1 BrS ECG pattern are changing. Casado-Arroyo et al in a prospective, dual-center registry, compared 447 patients with BrS type 1 ECG pattern diagnosed over nearly 30 years [15]. In patients diagnosed between 1986 and 2002 incidence of spontaneous type 1 ECG pattern was 52.7% (n=87), while in those diagnosed after 2002 (years range: 2003-2014) the percentage reached 26.2% (n=74) [15].…”

“…Casado-Arroyo et al in a prospective, dual-center registry, compared 447 patients with BrS type 1 ECG pattern diagnosed over nearly 30 years [15]. In patients diagnosed between 1986 and 2002 incidence of spontaneous type 1 ECG pattern was 52.7% (n=87), while in those diagnosed after 2002 (years range: 2003-2014) the percentage reached 26.2% (n=74) [15]. As expected, to unmask type 1 BrS ECG pattern in asymptomatic patients, sodium-channel blockers were used more frequently in the latter group (74.3% vs. 50.0%).…”

“…As expected, to unmask type 1 BrS ECG pattern in asymptomatic patients, sodium-channel blockers were used more frequently in the latter group (74.3% vs. 50.0%). Less frequent spontaneous type 1 ECG changes translated to a different clinical manifestation with lower rate of history of aborted SCD (4.6% vs. 12.1%), lower ventricular tachycardia (VT)/ventricular fibrillation (VF) inducibility in electrophysiological study (19.2% vs. 34.8%) and lower incidence of arrhythmic events (VF, SCD, appropriate shock) during follow-up [15].…”

“…Since 1992, when first detailed clinical description of BrS as a new clinical entity was published, there are several theories which aim to explain BrS pathophysiology [15,27]. Heterogenous genetic BrS basis implicates heterogenous BrS pathophysiological mechanisms [28].…”