Marco Bergonti, Frederic Sacher, Bernard Belhassen, Georgia Sarquella-Brugada, Elena Arbelo, Avi Sabbag, Lia Crotti, Jacob Tfelt-Hansen, Daniele Faccenda, Michela Casella, Konstantinos P Letsas, Andrea Rossi, Peter J Schwartz, Cinzia Monaco, Esther Scheirlynck, Luigi Pannone, Vincenzo Russo, Leonardo Calò, Maria Luce Caputo, Paola Berne, Alessandro Vicentini, Tardu Oezkartal, Federico Migliore, Sergio Conti, Paolo Compagnucci, Chiara Scrocco, Pedro Brugada, Carlo de Asmundis, Claudio Tondo, Josep Brugada, Vincent Probst, Elijah R Behr, Giulio Conte
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SSS was twice as prevalent in BrS patients with AF (10.0% vs 6.2%; P = 0.047), and stroke occurred exclusively in the AF group (2.5%), despite low CHA<sub>2</sub>DS<sub>2</sub>-VA (mean 0.5).</p><p><strong>Conclusions: </strong>The presence of AF in non-high-risk BrS does not identify patients with higher risk of VAs. However, early-onset AF (<20 years) defines a distinct subgroup with elevated risk. Patients with AF and BrS have a significantly higher risk of SSS and stroke.</p>","PeriodicalId":14573,"journal":{"name":"JACC. 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Non-high-risk BrS patients were stratified based on the presence or absence of AF. The primary endpoint was the occurrence of VAs, defined as sustained ventricular tachycardia, ventricular fibrillation, or arrhythmic sudden cardiac death.</p><p><strong>Results: </strong>A total of 686 BrS patients were analyzed (39.3 years of age, 33.1% female, 31.8% spontaneous type 1 electrocardiogram, 36.0% pathogenic/likely pathogenic SCN5A variant), including 280 with AF (40.8%). Proband status and older age were associated with AF at Cox regression analysis. Over a median follow-up of 48.8 months, the incidence of VAs was 0.26% per year, with no significant difference between patients with and without AF (HR: 0.67; P = 0.58). Early-onset AF (<20 years) was associated with significantly higher risk of VAs (P < 0.001). 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引用次数: 0
摘要
背景：高达20%的Brugada综合征（BrS）患者发生心房颤动（AF），但其危险因素和预后影响仍不确定。目的：本研究旨在确定非高危BrS患者房颤的危险因素，并评估房颤对非高危BrS患者室性心律失常（VAs）、病态窦性综合征（SSS）和卒中的影响。方法：这是一项在20个国际中心进行的多中心回顾性研究。非高危BrS患者根据是否存在房颤进行分层。主要终点是VAs的发生，定义为持续性室性心动过速、室性颤动或心律失常性心源性猝死。结果：共分析686例BrS患者（年龄39.3岁，女性33.1%，自发性1型心电图31.8%，致病性/可能致病性SCN5A变异36.0%），其中280例合并AF（40.8%）。Cox回归分析显示，先证者身份和年龄与房颤相关。在48.8个月的中位随访中，VAs的发生率为每年0.26%，有和没有房颤的患者之间无显著差异（HR: 0.67; P = 0.58）。早发性房颤（2DS2-VA，平均0.5）。结论：非高危BrS中房颤的存在并不能识别VAs风险较高的患者。然而，早发性房颤(
The Clinical Significance of Atrial Fibrillation in Non-High-Risk Brugada Syndrome: The BruFib Study.
Background: Atrial fibrillation (AF) occurs in up to 20% of patients with Brugada syndrome (BrS), yet its risk factors and prognostic implications remain uncertain.
Objectives: This study sought to identify risk factors for AF in patients with non-high-risk BrS and to evaluate the impact of AF on ventricular arrhythmias (VAs), sick sinus syndrome (SSS), and stroke in non-high-risk BrS.
Methods: This was a multicenter, retrospective study conducted across 20 international centers. Non-high-risk BrS patients were stratified based on the presence or absence of AF. The primary endpoint was the occurrence of VAs, defined as sustained ventricular tachycardia, ventricular fibrillation, or arrhythmic sudden cardiac death.
Results: A total of 686 BrS patients were analyzed (39.3 years of age, 33.1% female, 31.8% spontaneous type 1 electrocardiogram, 36.0% pathogenic/likely pathogenic SCN5A variant), including 280 with AF (40.8%). Proband status and older age were associated with AF at Cox regression analysis. Over a median follow-up of 48.8 months, the incidence of VAs was 0.26% per year, with no significant difference between patients with and without AF (HR: 0.67; P = 0.58). Early-onset AF (<20 years) was associated with significantly higher risk of VAs (P < 0.001). SSS was twice as prevalent in BrS patients with AF (10.0% vs 6.2%; P = 0.047), and stroke occurred exclusively in the AF group (2.5%), despite low CHA2DS2-VA (mean 0.5).
Conclusions: The presence of AF in non-high-risk BrS does not identify patients with higher risk of VAs. However, early-onset AF (<20 years) defines a distinct subgroup with elevated risk. Patients with AF and BrS have a significantly higher risk of SSS and stroke.
期刊介绍：
JACC: Clinical Electrophysiology is one of a family of specialist journals launched by the renowned Journal of the American College of Cardiology (JACC). It encompasses all aspects of the epidemiology, pathogenesis, diagnosis and treatment of cardiac arrhythmias. Submissions of original research and state-of-the-art reviews from cardiology, cardiovascular surgery, neurology, outcomes research, and related fields are encouraged. Experimental and preclinical work that directly relates to diagnostic or therapeutic interventions are also encouraged. In general, case reports will not be considered for publication.
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