Characteristics of Chinese patients with symptomatic Brugada syndrome in Taiwan.
Since 1992, the Brugada syndrome has been increasingly recognized worldwide, although its incidence and distribution remain unclear. In Asia, several cases have been reported in Japan, Thailand, Singapore, and Vietnam. However, little information is available from the Chinese population. Since June 1997, we have identified 10 patients with the diagnosis of the Brugada syndrome from six hospitals in Taiwan. All patients were male with the mean age of 46 +/- 7 years (range 36-61). They all had a normal chemistry profile, coronary angiography and echocardiography. Clinical presentations varied from seizure and syncope to sudden cardiac death. MRI and ultrafast CT of the heart did not show any abnormalities. Sustained ventricular tachycardia/ventricular fibrillation (VF) was induced in 7 of 8 patients who underwent an electrophysiologic study. The pharmacological provocation test was positive in 4 of 5 patients. One of the 4 patients who had a genetic study showed SCN5A gene mutation. An implantable cardioverter defibrillator (ICD) was implanted in 8 patients. During a mean follow-up of 29 +/- 17 months (range 2-54), 3 of 8 patients who had an ICD received appropriate ICD discharges after implantation. These 3 patients who were subsequently treated with antiarrhythmic agents have had no further recurrent ICD discharges. Two patients who refused ICD implantation are alive and well without taking antiarrhythmic agents. Our study showed that the clinical characteristics of our patients are similar to those described in the literature and that ICD is an effective treatment modality for patients with recurrent VF. However, antiarrhythmic agents may be beneficial for suppressing arrhythmia recurrences in selected patients.
Juang
Jyh-Ming
JM
National Taiwan University Hospital, Taipei, Taiwan.
Huang
Shoei K Stephen
SK
Tsai
Chia-Ti
CT
Chiang
Fu-Tien
FT
Lin
Jiunn-Lee
JL
Lai
Ling-Ping
LP
Wang
Chun-Chieh
CC
Kuo
Chi-Tai
CT
Ueng
Kwo-Chang
KC
Kong
Chi-Woon
CW
Ko
Wen-Chin
WC
Lei
Meng-Huan
MH
Tsao
Hsuan-Ming
HM
D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D006328:Cardiac Catheterization; D002681:China / Q000208:ethnology; D017023:Coronary Angiography; D015150:Echocardiography, Doppler; D015716:Electrocardiography, Ambulatory; D015444:Exercise; D005080:Exercise Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011342:Procainamide / Q000627:therapeutic use; D013577:Syndrome; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology* / Q000628:therapy; D013624:Taiwan; D014693:Ventricular Fibrillation / Q000208:ethnology / Q000503:physiopathology
D000889:Anti-Arrhythmia Agents; D011342:Procainamide