Relatively benign clinical course in asymptomatic patients with brugada-type electrocardiogram without family history of sudden death.
BACKGROUND
The incidence of sudden death or ventricular fibrillation (VF) in asymptomatic Brugada syndrome patients with a family history of sudden death is reported to be very high. However, there are few reports on the prognosis of asymptomatic Brugada syndrome patients without a family history of sudden death.


RESULTS
Eleven patients (all male; mean age 40.5 +/- 9.6 years, range 26 to 56) with asymptomatic Brugada-type ECG who had no family history of sudden death were evaluated. The degrees of ST segment elevation and conduction delay on signal-averaged ECG (SAECG) before and after pilsicainide were evaluated in all 11 patients. VF inducibility by ventricular electrical stimulation also was evaluated in 8 of 11 patients. Patients were followed for a period of 9 to 84 months (mean 42.5 +/- 21.6). The J point level was increased (V1: 0.19 +/- 0.09 mV to 0.36 +/- 0.23 mV; V2: 0.31 +/- 0.12 mV to 0.67 +/- 0.35 mV) by pilsicainide. Conduction delay was increased (total QRS: 112.2 +/- 6.3 msec to 131.7 +/- 6.3 msec; under 40 microV: 42.0 +/- 8.5 msec to 52.7 +/- 12.7 msec; last 40 msec: 17.4 +/- 5.9 microV to 10.4 +/- 6.1 microV) on SAECG by pilsicainide. VF was induced in only 1 of 8 patients. None of the patients had syncope or sudden death during a mean follow-up of 42.5 +/- 21.6 months.


CONCLUSIONS
This study suggests that asymptomatic patients with Brugada-type ECG who have no family history of sudden death have a relatively benign clinical course.
Takenaka
S
S
Department of Cardiovascular Disease, Okayama University Medical School, Japan. shiho@cc.okayama-u.ac.jp
Kusano
K F
KF
Hisamatsu
K
K
Nagase
S
S
Nakamura
K
K
Morita
H
H
Matsubara
H
H
Emori
T
T
Ohe
T
T
D000328:Adult; D000889:Anti-Arrhythmia Agents; D002037:Bundle-Branch Block / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology*; D016757:Death, Sudden, Cardiac; D004562:Electrocardiography; D004594:Electrophysiology; D005500:Follow-Up Studies; D006801:Humans; D008012:Lidocaine / Q000031:analogs & derivatives*; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009431:Neural Conduction; D011379:Prognosis; D011930:Reaction Time; D013577:Syndrome; D014693:Ventricular Fibrillation / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology*
D000889:Anti-Arrhythmia Agents; D008012:Lidocaine; C042288:pilsicainide