Long-term prognosis of probands with Brugada-pattern ST-elevation in leads V1-V3.
BACKGROUND
The prognosis of patients with saddleback or noncoved type (non-type 1) ST-elevation in Brugada syndrome is unknown. The purpose of this study was to clarify the long-term prognosis of probands with non-type 1 ECG and those with coved (type 1) Brugada-pattern ECG.


RESULTS
A total of 330 (123 symptomatic, 207 asymptomatic) probands with a coved or saddleback ST-elevation > or = 1 mm in leads V(1)-V(3) were divided into 2 ECG groups-type 1 (245 probands) and non-type 1 (85 probands)-and were prospectively followed for 48.7+/-15.0 months. The absence of type 1 ECG was confirmed by drug provocation test and multiple recordings. The ratio of individuals with a family history of sudden cardiac death (14%) was lower than previous studies. Clinical profiles and outcomes were not notably different between the 2 groups (annual arrhythmic event rate of probands with ventricular fibrillation; type 1: 10.2%, non-type 1: 10.6%, probands with syncope; type 1: 0.6%, non-type 1: 1.2%, and asymptomatic probands; type 1: 0.5%, non-type 1: 0%). Family history of sudden cardiac death at age <45 years and coexistence of inferolateral early repolarization with Brugada-pattern ECG were independent predictors of fatal arrhythmic events (hazard ratio, 3.28; 95% confidence interval, 1.42 to 7.60; P=0.005; hazard ratio, 2.66; 95% confidence interval, 1.06 to 6.71; P=0.03, respectively, by multivariate analysis), although spontaneous type 1 ECG and ventricular fibrillation inducibility by electrophysiological study were not reliable parameters.


CONCLUSIONS
The long-term prognosis of probands in non-type 1 group was similar to that of type 1 group. Family history of sudden cardiac death and the presence of early repolarization were predictors of poor outcome in this study, which included only probands with Brugada-pattern ST-elevation.
Division of Cardiology, National Cardiovascular Center, Suita, Osaka 565-8565, Japan. kamakura@hsp.ncvc.go.jp
Shiro
S
Kamakura
Tohru
T
Ohe
Kiyoshi
K
Nakazawa
Yoshifusa
Y
Aizawa
Akihiko
A
Shimizu
Minoru
M
Horie
Satoshi
S
Ogawa
Ken
K
Okumura
Kazufumi
K
Tsuchihashi
Kaoru
K
Sugi
Naomasa
N
Makita
Nobuhisa
N
Hagiwara
Hiroshi
H
Inoue
Hirotsugu
H
Atarashi
Naohiko
N
Aihara
Wataru
W
Shimizu
Takashi
T
Kurita
Kazuhiro
K
Suyama
Takashi
T
Noda
Kazuhiro
K
Satomi
Hideo
H
Okamura
Hitonobu
H
Tomoike
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053840:Brugada Syndrome / Q000401:mortality / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D016757:Death, Sudden, Cardiac; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors