title: Prevalence, clinical characteristics and management of atrial fibrillation in patients with Brugada syndrome.
abstract: Atrial fibrillation (AF) can be the first manifestation of latent Brugada syndrome (BS). The aim of our study was to assess the prevalence of AF as the first clinical diagnosis in patients with BS and their demographic and clinical characteristics and diagnosis management in a large cohort of patients. The patient group consisted of 611 patients with BS. The data from those with a diagnosis of AF previous to the identification of BS were analyzed (n = 35). Eleven cases were unmasked after the initiation of a class I antiarrhythmic drug and one during the establishment of general anesthesia. In the remaining population, BS was diagnosed using an ajmaline test performed mainly because of younger age in patients with lone AF (n = 13), previous syncope or sudden cardiac death (n = 3), or a clinical history of sudden cardiac death in the family (n = 5). The mean patient age was 49 ± 15 years, 21 were male patients, 14 had a family history of sudden death, 15 had had previous syncope, and 4 had survived cardiac arrest. Concomitant electrical disorder was found in 13 patients. Remarkably, 21 patients had normal findings on the baseline electrocardiogram. In conclusion, AF could be one of the first clinical manifestations of latent BS in a considerable number of patients. This identification is crucial because the treatment of these patients is subject to relevant changes. The ajmaline test plays an essential role, mainly in young patients with a family history of sudden death, despite having normal findings on a baseline electrocardiogram.
authors.affiliation: Heart Rhythm Management Center, Universitair Ziekenhuis Brussels - Vrije Universiteit Brussel, Belgium. moirmanero@gmail.com
authors.forename: Moisés
authors.initials: M
authors.lastname: Rodríguez-Mañero
authors.forename: Mehdi
authors.initials: M
authors.lastname: Namdar
authors.forename: Andrea
authors.initials: A
authors.lastname: Sarkozy
authors.forename: Rubén
authors.initials: R
authors.lastname: Casado-Arroyo
authors.forename: Danilo
authors.initials: D
authors.lastname: Ricciardi
authors.forename: Carlo
authors.initials: C
authors.lastname: de Asmundis
authors.forename: Gian-Battista
authors.initials: GB
authors.lastname: Chierchia
authors.forename: Kristel
authors.initials: K
authors.lastname: Wauters
authors.forename: Jayakeerthi Y
authors.initials: JY
authors.lastname: Rao
authors.forename: Fatih
authors.initials: F
authors.lastname: Bayrak
authors.forename: Sophie
authors.initials: S
authors.lastname: Van Malderen
authors.forename: Pedro
authors.initials: P
authors.lastname: Brugada
mesh_terms: D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D001530:Belgium / Q000453:epidemiology; D053840:Brugada Syndrome / Q000150:complications / Q000188:drug therapy*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000889:Anti-Arrhythmia Agents