Etiological diagnosis, prognostic significance and role of electrophysiological study in patients with Brugada ECG and syncope
Open accessAbstract
Background Syncope is considered a risk factor for life-threatening arrhythmias in Brugada patients. Distinguishing a benign syncope from one due to ventricular arrhythmias is often difficult, unless an ECG is recorded during the episode. Aim of the study was to analyze the characteristics of syncopal episodes in a large population of Brugada patients and evaluate the role of electrophysiological study (EPS) and the prognosis in the different subgroups.Methods and results One hundred ninety-five Brugada patients with history of syncope were considered. Syncope were classified as neurally mediated (group 1, 61%) or unexplained (group 2, 39%) on the basis of personal and family history, clinical features, triggers, situations, associated signs, concomitant therapy. Most patients underwent EPS; they received ICD or implantable loop-recorder on the basis of the result of investigations and physician's judgment. At 62±45months of mean follow-up, group 1 showed a significantly lower incidence of arrhythmic events (2%) as compared to group 2 (9%, p<0.001). Group 2 patients with positive EPS showed the highest risk of arrhythmic events (27%). No ventricular events occurred in subjects with negative EPS.Conclusion Etiological definition of syncope in Brugada patients is important, as it allows identifying two groups with different outcome. Patients with unexplained syncope and ventricular fibrillation induced at EPS have the highest risk of arrhythmic events. Patients presenting with neurally mediated syncope showed a prognosis similar to that of the asymptomatic and the role of EPS in this group is unproven.
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New studies published after the 2015 ESC Guidelines for ventricular arrhythmias and the prevention of sudden cardiac death showed that non-arrhythmic syncope is frequent in Brugada syndrome and appears to be more benign.
“New studies 356,365 published after the 2015 ESC Guidelines for VA and the prevention of SCD 46 showed that non-arrhythmic syncope is frequent in Brugada syndrome and appears to be more benign”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [365]
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References 26 · Cited by 36
- Authors
- Giustetto, C., Cerrato, N., Ruffino, E., Gribaudo, E., Scrocco, C., Barbonaglia, L., Bianchi, F., Bortnik, M., Rossetti, G., Carvalho, P., Riccardi, R., Castagno, D., Anselmino, M., Bergamasco, L., & Gaita, F.
- Affiliations
- Azienda Ospedaliera Citta' della Salute e della Scienza di Torino (IT)
- A. O. Ordine Mauriziano di Torino (IT)
- Azienda Ospedaliero Universitaria Maggiore della Carita (IT)
- Azienda Sanitaria Ospedaliera S.Croce e Carle Cuneo (IT)
- Ospedale San Luigi Gonzaga (IT)
- Ospedale Civile Edoardo Agnelli (IT)
- Corresponding author
- Giustetto, Carla
- ORCID
- Venue
- International Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2017-08
- Volume
- 241
- Pages
- 188-193
- ISSN
- 0167-5273 (ISSN-L)
- OpenAlex
- W2622967998
- Cited by
- 36
- References
- 26
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 7 · 2023: 5 · 2022: 1 · 2021: 2 · 2020: 5 · 2019: 3 · 2018: 4 · 2017: 3
- FWCI
- 4.22
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- International Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- St George's Online Research Archive (St George's University of London) (acceptedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Keywords
- Brugada syndrome, syncope, neurally mediated syncope, unexplained syncope, electrophysiological study, ventricular arrhythmias, ventricular fibrillation, implantable cardioverter-defibrillator, implantable loop recorder, prognosis, arrhythmia risk
- MeSH terms
- Adult, Electrocardiography, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Registries, Syncope, Brugada Syndrome, Electrophysiological Phenomena
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