Long-term prognosis of women with Brugada syndrome and electrophysiological study.

Adult Brugada Syndrome / complications Death, Sudden, Cardiac / epidemiology Electrocardiography / methods Female Follow-Up Studies Humans Incidence Male Portugal / epidemiology Prognosis Retrospective Studies Risk Assessment / methods Risk Factors Spain / epidemiology Survival Rate / trends Time Factors Women's Health

Brugada syndrome Electrophysiological study Sudden cardiac death Ventricular arrhythmias Women

Journal

Heart rhythm

ISSN: 1556-3871

Titre abrégé: Heart Rhythm

Pays: United States

ID NLM: 101200317

Informations de publication

Date de publication:
05 2021

Historique:

received: 22 10 2020

revised: 15 12 2020

accepted: 19 12 2020

pubmed: 29 12 2020

medline: 19 1 2022

entrez: 28 12 2020

Statut: ppublish

Résumé

A male predominance in Brugada syndrome (BrS) has been widely reported, but scarce information on female patients with BrS is available. The purpose of this study was to investigate the clinical characteristics and long-term prognosis of women with BrS. A multicenter retrospective study of patients diagnosed with BrS and previous electrophysiological study (EPS) was performed. Among 770 patients, 177 (23%) were female. At presentation, 150 (84.7%) were asymptomatic. Females presented less frequently with a type 1 electrocardiographic pattern (30.5% vs 55.0%; P <.001), had a higher rate of family history of sudden cardiac death (49.7% vs 29.8%; P <.001), and had less sustained ventricular arrhythmias (VAs) on EPS (8.5% vs 15.1%; P = .009). Genetic testing was performed in 79 females (45% of the sample) and was positive in 34 (19%). An implantable cardioverter-defibrillator was inserted in 48 females (27.1%). During mean (± SD) follow-up of 122.17 ± 57.28 months, 5 females (2.8%) experienced a cardiovascular event compared to 42 males (7.1%; P = .04). On multivariable analysis, a positive genetic test (18.71; 95% confidence interval [CI] 1.82-192.53; P = .01) and atrial fibrillation (odds ratio 21.12; 95% CI 1.27-350.85; P = .03) were predictive of arrhythmic events, whereas VAs on EPS (neither with 1 or 2 extrastimuli nor 3 extrastimuli) were not. Women with BrS represent a minor fraction among patients with BrS, and although their rate of events is low, they do not constitute a risk-free group. Neither clinical risk factors nor EPS predicts future arrhythmic events. Only atrial fibrillation and positive genetic test were identified as risk factors for future arrhythmic events.

Sections du résumé

BACKGROUND

A male predominance in Brugada syndrome (BrS) has been widely reported, but scarce information on female patients with BrS is available.

OBJECTIVE

The purpose of this study was to investigate the clinical characteristics and long-term prognosis of women with BrS.

METHODS

A multicenter retrospective study of patients diagnosed with BrS and previous electrophysiological study (EPS) was performed.

RESULTS

Among 770 patients, 177 (23%) were female. At presentation, 150 (84.7%) were asymptomatic. Females presented less frequently with a type 1 electrocardiographic pattern (30.5% vs 55.0%; P <.001), had a higher rate of family history of sudden cardiac death (49.7% vs 29.8%; P <.001), and had less sustained ventricular arrhythmias (VAs) on EPS (8.5% vs 15.1%; P = .009). Genetic testing was performed in 79 females (45% of the sample) and was positive in 34 (19%). An implantable cardioverter-defibrillator was inserted in 48 females (27.1%). During mean (± SD) follow-up of 122.17 ± 57.28 months, 5 females (2.8%) experienced a cardiovascular event compared to 42 males (7.1%; P = .04). On multivariable analysis, a positive genetic test (18.71; 95% confidence interval [CI] 1.82-192.53; P = .01) and atrial fibrillation (odds ratio 21.12; 95% CI 1.27-350.85; P = .03) were predictive of arrhythmic events, whereas VAs on EPS (neither with 1 or 2 extrastimuli nor 3 extrastimuli) were not.

CONCLUSION

Women with BrS represent a minor fraction among patients with BrS, and although their rate of events is low, they do not constitute a risk-free group. Neither clinical risk factors nor EPS predicts future arrhythmic events. Only atrial fibrillation and positive genetic test were identified as risk factors for future arrhythmic events.

Identifiants

DOI: 10.1016/j.hrthm.2020.12.020 PMID: 33359877

pubmed: 33359877

pii: S1547-5271(20)31215-7

doi: 10.1016/j.hrthm.2020.12.020

pii:

doi:

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

Pagination

664-671

Commentaires et corrections

Type : CommentIn