The incidence and prognosis of Brugada electrocardiographic pattern in the Manitoba Follow-Up Study.
BACKGROUND
There is a paucity of long-term follow-up data on individuals with asymptomatic Brugada electrocardiographic (ECG) pattern.


OBJECTIVE
To investigate the incidence and prognosis of spontaneous Brugada ECG pattern in a prospective cohort.


METHODS
The Manitoba Follow-up Study is Canada's longest-running study of cardiovascular disease. Since 1948, a cohort of 3983 healthy aircrew recruits has been followed with routine medical examination, including ECG. Over a 55-year follow-up period, clinical and ECG assessments were performed every three to five years, with yearly contact to monitor vital status. The mean age of the cohort at entry and the average age of the 1375 survivors in 2003 were 31 and 83 years of age, respectively. Brugada ECG pattern was defined as ST-segment elevation in at least one of leads V1 to V3 with a J wave amplitude of at least 2 mm, negative T waves, generally coved ST-T configuration, in the absence of alternative explanations. Serial ECGs of 273 subjects (6.9% of the cohort) with complete right bundle branch block at any time during follow-up were reviewed. Follow-up records pertaining to clinical course were also reviewed.


RESULTS
All ECGs (in total 5665) from this cohort were reviewed. Four men had intermittent Brugada ECG pattern (lifetime incidence one per 1000): three men (all 80 years of age or older) were well on last follow-up and one had died of Alzheimer's disease. None of these men had syncope or ventricular arrhythmias documented during follow-up.


CONCLUSIONS
The longevity of asymptomatic individuals in this cohort was not affected by spontaneous Brugada ECG pattern.
Lee
Candace
C
Department of Physiology, Institute of Cardiovascular Sciences, St. Boniface General Hospital Research Centre, Winnipeg, Manitoba.
Soni
Anita
A
Tate
Robert B
RB
Cuddy
T Edward
TE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002037:Bundle-Branch Block / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000517:prevention & control*; D004562:Electrocardiography; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D008875:Middle Aged; D011379:Prognosis