Prevalence and prognostic role of various conduction disturbances in patients with the Brugada syndrome
Abstract
Prevalence and prognostic value of conduction disturbances in patients with the Brugada syndrome (BrS) remains poorly known. Electrocardiograms (ECGs) from 325 patients with BrS (47 ± 13 years, 258 men) with spontaneous (n = 143) or drug-induced (n = 182) type 1 ECG were retrospectively reviewed. Two hundred twenty-six patients (70%) were asymptomatic, 73 patients (22%) presented with unexplained syncope, and 26 patients (8%) presented with sudden death or implantable cardioverter-defibrillator appropriated therapies at diagnosis or during a mean follow-up of 48 ± 34 months. P-wave duration of ≥120 ms was present in 129 patients (40%), first degree atrioventricular block (AVB) in 113 (35%), right bundle branch block (BBB) in 90 (28%), and fascicular block in 52 (16%). Increased P-wave duration, first degree AVB, and right BBB were more often present in patients after drug challenge than in patients with spontaneous type 1 ST elevation. Left BBB was present in 3 patients. SCN5A mutation carriers had longer P-wave duration and longer PR and HV intervals. In multivariate analysis, first degree AVB was independently associated with sudden death or implantable cardioverter-defibrillator appropriated therapies (odds ratio 2.41, 95% confidence interval 1.01 to 5.73, p = 0.046) together with the presence of syncope and spontaneous type 1 ST elevation. In conclusion, conduction disturbances are frequent and sometimes diffuse in patients with BrS. First degree AVB is independently linked to outcome and may be proposed to be used for individual risk stratification.
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A drug-induced type 1 ECG pattern has a lower risk of sudden death than a spontaneous type 1 response in Brugada syndrome.
“A drug-induced type 1 ECG pattern has a lower risk of sudden death than a spontaneous type 1 response.”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [368]
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Self-citation
- Authors
- Maury, P., Rollin, A., Sacher, F., Gourraud, J.-B., Raczka, F., Pasquié, J.-L., Duparc, A., Mondoly, P., Cardin, C., Delay, M., Derval, N., Chatel, S., Bongard, V., Sadron, M., Denis, A., Davy, J.-M., Hocini, M., Jaïs, P., Jesel, L., Haïssaguerre, M., & Probst, V.
- Affiliations
- Hôpital Rangueil (FR)
- Hôpital Cardiologique du Haut-Lévêque (FR)
- Institut du Thorax (FR)
- Hôpital Arnaud de Villeneuve (FR)
- Corresponding author
- Maury, Philippe
- ORCID
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2013-11
- Volume
- 112
- Issue
- 9
- Pages
- 1384-1389
- ISSN
- 0002-9149 (ISSN-L)
- OpenAlex
- W1997696957
- Cited by
- 111
- References
- 31
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 6 · 2023: 5 · 2022: 3 · 2021: 8 · 2020: 8 · 2019: 17 · 2018: 12 · 2017: 15 · 2016: 13 · 2015: 14 · 2014: 4
- FWCI
- 7.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Keywords
- Brugada syndrome, cardiac conduction disorders, first-degree atrioventricular block, right bundle branch block, P-wave duration, sudden cardiac death, implantable cardioverter-defibrillator, syncope, SCN5A mutation, risk stratification, drug-induced ECG changes
- MeSH terms
- Electrocardiography, Female, Follow-Up Studies, France, Heart Conduction System, Humans, Male, Middle Aged, Prognosis, Retrospective Studies, Prevalence, Survival Rate, Confidence Intervals, Odds Ratio, Death, Sudden, Cardiac, Brugada Syndrome
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