title: Syncope in Brugada syndrome patients: prevalence, characteristics, and outcome.
abstract: BACKGROUND
  The report from the 2nd Consensus Committee on BrS suggests that all patients with syncope without a "clear extracardiac cause" should have an implantable cardioverter-defibrillator (ICD). However, a clear extracardiac cause for syncope may be difficult to prove.
  
  
  OBJECTIVE
  The purpose of this study was to characterize syncope in patients with Brugada syndrome (BrS).
  
  
  METHODS
  All patients diagnosed with BrS at our institution between 1999 and 2010 were enrolled in a prospective registry. Patients with suspected arrhythmic syncope (group 1) were compared to patients with nonarrhythmic syncope (group 2) and to patients with syncope of doubtful origin (group 3).
  
  
  RESULTS
  Of 203 patients with BrS, 57 (28%; 44 male, age 46 ± 12 years) experienced at least 1 syncope. Group 1 consisted of 23 patients, all of whom received an ICD. In group 2 (17 patients), 3 received an ICD because of a positive electrophysiologic study. In group 3 (17 patients), 6 received an implantable loop recorder and 6 received an ICD. After mean follow-up of 65 ± 42 months, 14 patients in group 1 remained asymptomatic, 4 had recurrent syncope, and 6 had appropriate ICD therapy. In group 2, 9 patients remained asymptomatic and 7 had recurrent neurocardiogenic syncope. In group 3, 7 remained asymptomatic and 9 had recurrent syncope. One patient from each group died from a noncardiac cause.
  
  
  CONCLUSIONS
  In the present study, syncope occurred in 28% of patients with BrS. The ventricular arrhythmia rate was 5.5% per year in group 1. In 30%, the etiology of the syncope was questionable. No sudden cardiac death occurred in groups 2 and 3.
authors.affiliation: Bordeaux University Hospital, Bordeaux, France. frederic.sacher@chu-bordeaux.fr
authors.forename: Frédéric
authors.initials: F
authors.lastname: Sacher
authors.forename: Florence
authors.initials: F
authors.lastname: Arsac
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Wilton
authors.forename: Nicolas
authors.initials: N
authors.lastname: Derval
authors.forename: Arnaud
authors.initials: A
authors.lastname: Denis
authors.forename: Maxime
authors.initials: M
authors.lastname: de Guillebon
authors.forename: Khaled
authors.initials: K
authors.lastname: Ramoul
authors.forename: Pierre
authors.initials: P
authors.lastname: Bordachar
authors.forename: Philippe
authors.initials: P
authors.lastname: Ritter
authors.forename: Mélèze
authors.initials: M
authors.lastname: Hocini
authors.forename: Jacques
authors.initials: J
authors.lastname: Clémenty
authors.forename: Pierre
authors.initials: P
authors.lastname: Jaïs
authors.forename: Michel
authors.initials: M
authors.lastname: Haïssaguerre
mesh_terms: D000328:Adult; D053840:Brugada Syndrome / Q000453:epidemiology*; D017147:Defibrillators, Implantable; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013575:Syncope / Q000453:epidemiology*; D014693:Ventricular Fibrillation