Prevalence of supraventricular tachyarrhythmias in a cohort of 115 patients with Brugada syndrome.
BACKGROUND
The Brugada syndrome is characterized by ST segment elevation in leads V(1) to V(3) and a right bundle branch block like pattern. It is associated with an increased risk of syncope and sudden cardiac death. Initial reports in small numbers of patients suggest an association between supraventricular tachycardias and Brugada syndrome with a prevalence varying between 13% and 40%.


OBJECTIVE
Aim of this study was to evaluate the prevalence of AV nodal reentrant tachycardia, AV reentry tachycardia, and/or atrial fibrillation in a large cohort of patients diagnosed as Brugada syndrome.


RESULTS
From three different European centers 115 consecutive patients with a Brugada syndrome were evaluated noninvasively and invasively (mean age 45 +/- 12 years, n = 82 men, n = 33 women). Nineteen of 115 patients (17%) had a history of previous cardiac arrest. Syncope was reported by 58 patients (50%), 33 patients had a positive family history of sudden cardiac death (29%). Supraventricular tachycardias were documented in 26 of the patients (23%): Eight patients (7%) had AV-nodal reentrant tachycardias and two patients had AV-reentry tachycardias; atrial tachycardias were documented in three patients, and another 13 patients (11%) suffered from atrial fibrillation/atrial flutter. Additionally, atrial fibrillation was inducible by programmed atrial stimulation in nine patients (8%).


CONCLUSIONS
Supraventricular tachycardias occur in 23% of patients with Brugada syndrome. Documentation of atrial fibrillation especially in the young or supraventricular tachycardias associated with syncope should give reason to screen for Brugada syndrome.
Schimpf
Rainer
R
First Department of Medicine, Division of Cardiology, University Hospital Mannheim, Germany. rainer.schimpf@med.ma.uni-heidelberg.de
Giustetto
Carla
C
Eckardt
Lars
L
Veltmann
Christian
C
Wolpert
Christian
C
Gaita
Fiorenzo
F
Breithardt
Günter
G
Borggrefe
Martin
M
D000328:Adult; D017677:Age Distribution; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology; D001282:Atrial Flutter / Q000175:diagnosis / Q000453:epidemiology; D053840:Brugada Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D002423:Cause of Death; D015331:Cohort Studies; D015897:Comorbidity; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D015996:Survival Rate; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000175:diagnosis / Q000453:epidemiology; D013617:Tachycardia, Supraventricular / Q000175:diagnosis* / Q000453:epidemiology*