title: Prevalence and prognostic role of various conduction disturbances in patients with the Brugada syndrome.
abstract: Prevalence and prognostic value of conduction disturbances in patients with the Brugada syndrome (BrS) remains poorly known. Electrocardiograms (ECGs) from 325 patients with BrS (47 ± 13 years, 258 men) with spontaneous (n = 143) or drug-induced (n = 182) type 1 ECG were retrospectively reviewed. Two hundred twenty-six patients (70%) were asymptomatic, 73 patients (22%) presented with unexplained syncope, and 26 patients (8%) presented with sudden death or implantable cardioverter-defibrillator appropriated therapies at diagnosis or during a mean follow-up of 48 ± 34 months. P-wave duration of ≥120 ms was present in 129 patients (40%), first degree atrioventricular block (AVB) in 113 (35%), right bundle branch block (BBB) in 90 (28%), and fascicular block in 52 (16%). Increased P-wave duration, first degree AVB, and right BBB were more often present in patients after drug challenge than in patients with spontaneous type 1 ST elevation. Left BBB was present in 3 patients. SCN5A mutation carriers had longer P-wave duration and longer PR and HV intervals. In multivariate analysis, first degree AVB was independently associated with sudden death or implantable cardioverter-defibrillator appropriated therapies (odds ratio 2.41, 95% confidence interval 1.01 to 5.73, p = 0.046) together with the presence of syncope and spontaneous type 1 ST elevation. In conclusion, conduction disturbances are frequent and sometimes diffuse in patients with BrS. First degree AVB is independently linked to outcome and may be proposed to be used for individual risk stratification.
authors.affiliation: Department of Cardiology, University Hospital Rangueil, Toulouse, France. Electronic address: maury.p@chu-toulouse.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Maury
authors.forename: Anne
authors.initials: A
authors.lastname: Rollin
authors.forename: Frédéric
authors.initials: F
authors.lastname: Sacher
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Gourraud
authors.forename: Franck
authors.initials: F
authors.lastname: Raczka
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Pasquié
authors.forename: Alexandre
authors.initials: A
authors.lastname: Duparc
authors.forename: Pierre
authors.initials: P
authors.lastname: Mondoly
authors.forename: Christelle
authors.initials: C
authors.lastname: Cardin
authors.forename: Marc
authors.initials: M
authors.lastname: Delay
authors.forename: Nicolas
authors.initials: N
authors.lastname: Derval
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Chatel
authors.forename: Vanina
authors.initials: V
authors.lastname: Bongard
authors.forename: Marie
authors.initials: M
authors.lastname: Sadron
authors.forename: Arnaud
authors.initials: A
authors.lastname: Denis
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Davy
authors.forename: Mélèze
authors.initials: M
authors.lastname: Hocini
authors.forename: Pierre
authors.initials: P
authors.lastname: Jaïs
authors.forename: Laurence
authors.initials: L
authors.lastname: Jesel
authors.forename: Michel
authors.initials: M
authors.lastname: Haïssaguerre
authors.forename: Vincent
authors.initials: V
authors.lastname: Probst
mesh_terms: D053840:Brugada Syndrome / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D016001:Confidence Intervals; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006329:Heart Conduction System / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends