Atrial Fibrillation in Patients With Brugada Syndrome
Open accessAbstract
Objectives The goal of our work was to examine the relationships of atrial fibrillation (AF) with genetic, clinical, and electrophysiological backgrounds in Brugada syndrome (BrS).Background Atrial fibrillation is often observed in patients with BrS and indicates that electrical abnormality might exist in the atrium as well as in the ventricle. SCN5A, a gene encoding the cardiac sodium channel, has been reported to be causally related to BrS. However, little is known about the relationships of atrial arrhythmias with genetic, clinical, and electrophysiological backgrounds of BrS.Methods Seventy-three BrS patients (49 +/- 12 years of age, men/women = 72/1) were studied. The existence of SCN5A mutation and clinical variables (syncopal episode, documented ventricular fibrillation [VF], and family history of sudden death) were compared with spontaneous AF episodes. Genetic and clinical variables were also compared with electrophysiologic (EP) parameters: atrial refractory period, interatrial conduction time (CT), repetitive atrial firing, and AF induction by atrial extra-stimulus testing.Results Spontaneous AF occurred in 10 (13.7%) of the BrS patients and SCN5A mutation was detected in 15 patients. Spontaneous AF was associated with higher incidence of syncopal episodes (60.0% vs. 22.2%, p < 0.03) and documented VF (40.0% vs. 14.3%, p < 0.05). SCN5A mutation was associated with prolonged CT (p < 0.03) and AF induction (p < 0.05) in EP study, but not related to the spontaneous AF episode and other clinical variables. In patients with documented VF, higher incidence of spontaneous AF (30.8% vs. 10.0%, p < 0.05), AF induction (53.8% vs. 20.0%, p < 0.03), and prolonged CT was observed.Conclusions Spontaneous AF and VF are closely linked clinically and electrophysiologically in BrS patients. Patients with spontaneous AF have more severe clinical backgrounds in BrS. SCN5A mutation is associated with electrical abnormality but not disease severity.
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In Brugada syndrome, spontaneous atrial fibrillation, occurring mostly at night, and atrial vulnerability are important predictors of ventricular fibrillation events that cause sudden cardiac death.
“A study by Kusano and coworkers 32 examined the relationships of atrial fibrillation with genetic, clinical and electrophysiological backgrounds in BS and showed that spontaneous AF, occurring mostly at night, and atrial vulnerability are important predictors of VF events that cause sudden cardiac death.”
From The Year of 2008 in Electrocardiology (2010) · cites this paper as [32]
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- Authors
- Kusano, K. F., Taniyama, M., Nakamura, K., Miura, D., Banba, K., Nagase, S., Morita, H., Nishii, N., Watanabe, A., Tada, T., Murakami, M., Miyaji, K., Hiramatsu, S., Nakagawa, K., Tanaka, M., Miura, A., Kimura, H., Fuke, S., Sumita, W., Sakuragi, S., Urakawa, S., Iwasaki, J., & Ohe, T.
- Affiliations
- Okayama University (JP)
- Corresponding author
- Kusano, Kengo F.
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2008-03
- Volume
- 51
- Issue
- 12
- Pages
- 1169-1175
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2265361147
- Cited by
- 190
- References
- 24
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 6 · 2023: 8 · 2022: 5 · 2021: 7 · 2020: 9 · 2019: 12 · 2018: 5 · 2017: 19 · 2016: 14 · 2015: 13 · 2014: 10 · 2013: 13 · 2012: 13
- FWCI
- 11.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Education, Culture, Sports, Science and Technology (17689026)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Keywords
- Brugada syndrome, atrial fibrillation, SCN5A mutation, cardiac sodium channel, ventricular fibrillation, syncope, interatrial conduction time, atrial refractory period, atrial arrhythmias, sudden cardiac death
- MeSH terms
- Adult, Atrial Fibrillation, Electrocardiography, Electrophysiology, Female, Heart Conduction System, Humans, Male, Middle Aged, Muscle Proteins, Mutation, Severity of Illness Index, Sodium Channels, Tachycardia, Ventricular, Brugada Syndrome, NAV1.5 Voltage-Gated Sodium Channel
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