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Prevalence of spontaneous type I ECG pattern, syncope, and other risk markers in sudden cardiac arrest survivors with Brugada syndrome

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Title: Prevalence of spontaneous type I ECG pattern, syncope, and other risk markers in sudden cardiac arrest survivors with Brugada syndrome
Authors: Leong, KMW
Ng, FS
Jones, S
Chow, J-J
Qureshi, N
Koa-Wing, M
Linton, NWF
Whinnett, ZI
Lefroy, DC
Davies, DW
Lim, PB
Peters, NS
Kanagaratnam, P
Varnava, AM
Item Type: Journal Article
Abstract: Introduction A spontaneous type I electrocardiogram (ECG) pattern and/or unheralded syncope are conventionally used as risk markers for primary prevention of sudden cardiac arrest/death (SCA/SCD) in Brugada syndrome (BrS). In this study, we determine the prevalence of conventional and newer markers of risk in those with and without previous aborted SCA events. Methods All patients with BrS were identified at our institute. History of symptoms was obtained from medical tests or from interviews. Other markers of risk were also obtained, such as presence of (1) spontaneous type I pattern, (2) fractionated QRS (fQRS), (3) early repolarization (ER) pattern, (4) late potentials on signal‐averaged ECG (SAECG), and (5) response to programmed electrical stimulation. Results In 133 patients with Bars, 10 (7%) patients (mean age = 39 ± 11 years; nine males) were identified with a previous ventricular fibrillation/ventricular tachycardia episode (n = 8) or requiring cardio‐pulmonary resuscitation (n = 2). None of these patients had a prior history of syncope before their SCA event. Only two (20%) patients reported a history of palpitations or dizziness. None had apneic breathing and three (30%) patients had a family history of SCA. From their ECGs, a spontaneous pattern was only found in one (10%) of these patients. Further, 10% of patients had fQRS, 17% had late potentials on SAECG, 20% had deep S waves in lead I, and 10% had an ER pattern in the peripheral leads. No significant differences were observed in the non‐SCA group. Conclusion The majority of BrS patients with previous aborted SCA events did not have a spontaneous type I and/or prior history of syncope. Conventional and newer markers of risk appear to only have limited ability to predict SCA.
Issue Date: 1-Feb-2019
Date of Acceptance: 24-Nov-2018
URI: http://hdl.handle.net/10044/1/75438
DOI: 10.1111/pace.13587
ISSN: 0147-8389
Publisher: Wiley
Start Page: 257
End Page: 264
Journal / Book Title: PACE - Pacing and Clinical Electrophysiology
Volume: 42
Issue: 2
Copyright Statement: © 2018 Wiley Periodicals, Inc. This is the accepted version of the following article: Leong, KMW, Ng, FS, Jones, S, et al. Prevalence of spontaneous type I ECG pattern, syncope, and other risk markers in sudden cardiac arrest survivors with Brugada syndrome. Pacing Clin Electrophysiol. 2019;42: 257– 264, which has been published in final form at https://doi.org/10.1111/pace.13587
Sponsor/Funder: Daniel Bagshaw Memorial Trust
British Heart Foundation
British Heart Foundation
Rosetrees Trust
Imperial College Healthcare NHS Trust- BRC Funding
Funder's Grant Number: n/a
PG/15/20/31339
FS/11/22/28745
A1407/ M645
RDB02
Keywords: Science & Technology
Life Sciences & Biomedicine
Technology
Cardiac & Cardiovascular Systems
Engineering, Biomedical
Cardiovascular System & Cardiology
Engineering
Brugada syndrome
risk stratification
sudden cardiac arrest
IDIOPATHIC VENTRICULAR-FIBRILLATION
ST-SEGMENT ELEVATION
ELECTROCARDIOGRAPHIC PARAMETERS
CONSENSUS CONFERENCE
J-WAVE
STRATIFICATION
DEATH
STIMULATION
MULTICENTER
EXERCISE
Brugada syndrome
risk stratification
sudden cardiac arrest
Science & Technology
Life Sciences & Biomedicine
Technology
Cardiac & Cardiovascular Systems
Engineering, Biomedical
Cardiovascular System & Cardiology
Engineering
Brugada syndrome
risk stratification
sudden cardiac arrest
IDIOPATHIC VENTRICULAR-FIBRILLATION
ST-SEGMENT ELEVATION
ELECTROCARDIOGRAPHIC PARAMETERS
CONSENSUS CONFERENCE
J-WAVE
STRATIFICATION
DEATH
STIMULATION
MULTICENTER
EXERCISE
Cardiovascular System & Hematology
0903 Biomedical Engineering
1103 Clinical Sciences
Publication Status: Published
Open Access location: https://onlinelibrary.wiley.com/doi/abs/10.1111/pace.13587
Online Publication Date: 2018-12-20
Appears in Collections:Bioengineering
National Heart and Lung Institute
Faculty of Medicine



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