Long-Term Follow-Up of Patients with Brugada Syndrome: Foremost Risk Factors Associated with Arrhythmic Events

Abstract

Background: Brugada syndrome (BS) is characterized by ST segment elevation in right precordial leads (V1-3), ventricular tachycardia (VT), ventricular fibrillation (VF) and sudden cardiac death (SCD) in individuals without structural heart disease. The aim of this study was to assess parameters associated with in patients with BS. Methods: A total of 68 patients diagnosed with BS or had Brugada Type ECG Change (BTEC) between January 1997 and July 2012 at the Department of Cardiology of Başkent University Faculty of Medicine, Ankara, Turkey were included. Patients were screened every 6 months for arrhythmia-related syncope, SCD, appropriate and inappropriate defibrillation (shock), AF development and death; collectively defined as “arrhythmic events” and were the primary endpoints. Patients with and without arrhythmic events were compared. Results: The mean age was 34.9 ± 12.2 years (9-71 years), and 52 (76.5%) patients were male. Mean follow-up was 49.6 ± 37.6 months (4-188 months). Univariate analysis showed that male sex (p = 0.004), Type 1 electrocardiographic pattern (p = 0.008), SCD (p = 0.036), VT/VF history (p = 0.046), requirement for electrophysiological studies (p = 0.034), implantable cardioverter-defibrillator (ICD) placement (p = 0.014) was found to demonstrate significant differences in patients with and without arrhythmic events. In multivariable analyzes, spontaneous Type 1 ECG presence (HR = 8.54, 95% CI: 0.38-26.37; p = 0.003) and VT/VF history (HR = 9.21, 95% CI: 0.004-1.88; p = 0.002) were found to be independently associated with arrhythmic events. Conclusion: We found the presence of spontaneous type 1 ECG and a history of VT/VF to be associated with increased likelihood of arrhythmic events in BS. Comprehensive studies investigating factors that could be used for risk assessment are necessary.