title: [Possible prognostic value of atrial fibrillation and atrial flutter in Brugada syndrome].
abstract: OBJECTIVE
  To analyze the specific risk for the variables: type 1 spontaneous pattern, type 1 induced pattern, type 1 pattern with spontaneous variability, syncope, family history of sudden death, atrial fibrillation and atrial flutter with the subsequent development of malignant arrhythmic events.
  
  
  METHODS
  Forty-three Brugada patients (90% males; mean age 40.4 years), with a type 1 spontaneous pattern (74.4%) or induced by ajmaline (25.6%) were retrospectively analyzed. Of these, 58.1% presented spontaneous variability, 18.6% had family history of sudden death, 39.5% were symptomatic, and 18.6% presented atrial fibrillation or atrial flutter. The antecedents of resuscitated cardiac arrest, sudden death or appropriate shock from implantable automatic defibrillator were considered malignant arrhythmic events. During a mean follow up of 51 months, no deaths were recorded, 6.9% of the patients presented a malignant arrhythmic event, and all of them were appropriate shocks. The annual rate of events in patients with syncope was 1.7%, with a spontaneous type 1 pattern was 2.79%, and spontaneous variability was 2.87%. No malignant arrhythmic event was observed in asymptomatic patients or in those with a persistent pattern or induced type 1 pattern. The annual rate of events with positive or negative history of family sudden death was 2.94 and 1.7%, respectively. In the presence of atrial fibrillation, atrial flutter and atrial fibrillation/atrial flutter were 7.3, 15.69 and 10%, respectively. In the absence of atrial fibrillation/atrial flutter no malignant arrhythmic events were observed.
  
  
  CONCLUSIONS
  Of the variables analyzed, the one that was most related to a malignant arrhythmic event was the presence of atrial fibrillation (P=.046) and atrial flutter (P=.03).
authors: Servicio de Cardiología, Sanatorio San Gerónimo, Santa Fe Capital, Santa Fe, Argentina. Electronic address: marcelo_abud@ciudad.com.ar.
authors: Atilio
authors: A
authors: Abud
authors: Raúl
authors: R
authors: Goyeneche
authors: Adrian
authors: A
authors: Carlessi
authors: Bruno
authors: B
authors: Strada
authors: Carlos
authors: C
authors: Becker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000209:etiology*; D001282:Atrial Flutter / Q000209:etiology*; D053840:Brugada Syndrome / Q000145:classification / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D055815:Young Adult