Prevalence and clinical course of the juveniles with Brugada-type ECG in Japanese population.
BACKGROUND
Although many studies on Brugada syndrome have been done, with many reports of genetic findings and clinical features, little evidence exists to support the role of this syndrome in sudden cardiac death in a juvenile population. We sought to determine the prevalence and clinical course in children exhibiting Brugada-type ECG in a community-based population.


METHODS
Our study population comprised 21,944 subjects (11,282 boys and 10,662 girls) who underwent ECG during their first-year elementary school health examinations between 1992 and 2001 in Izumi City, Osaka. Brugada-type ECG was defined as demonstrating ST-segment elevation (coved or saddle-back type, J wave amplitude > or =0.2 mV) in the right precordial leads. We also divided Brugada-type ECGs into three types according to a consensus report. Type 1: coved ST-segment elevation displaying high J wave amplitude followed by a negative T wave; Type 2: high take-off and gradually descending ST-segment elevation (remaining > or =1 mm) followed by a positive or biphasic T wave; and Type 3: ST-segment elevation of <1 mm of both types.


RESULTS
Four subjects showed Brugada-type ECG (0.02%) (2 boys and 2 girls). Only one subject, a girl, met Type 1 criteria (0.005%). No history of structural heart disease was documented in these four subjects. During 6.8 +/- 1.0 years of follow-up, no episode of unexpected sudden death, syncopal attack, and fatal arrhythmia occurred.


CONCLUSIONS
The prevalence of Brugada-type ECG in a juvenile population was extremely low. To investigate when the typical Brugada-type ECG might be manifested, it could be necessary to check ECGs after adolescence.
Oe
Hiroki
H
Department of Internal Medicine and Cardiology, Osaka City University, Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
Takagi
Masahiko
M
Tanaka
Atsushi
A
Namba
Masashi
M
Nishibori
Yoshiharu
Y
Nishida
Yukio
Y
Kawarabayashi
Takahiko
T
Yoshiyama
Minoru
M
Nishimoto
Masaki
M
Tanaka
Kumeo
K
Yoshikawa
Junichi
J
D002037:Bundle-Branch Block / Q000208:ethnology* / Q000503:physiopathology; D002648:Child; D016757:Death, Sudden, Cardiac; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D015995:Prevalence; D013577:Syndrome