title: Clinical characteristics, management, and prognosis of elderly patients with Brugada syndrome.
abstract: BACKGROUND
  The clinical course and prognosis of Brugada syndrome (BS) in the elderly is unknown. The purpose of this study was to investigate the clinical characteristics, management, and prognosis of BS in an elderly population.
  
  
  RESULTS
  A total of 437 patients with BS were included in this study. Patients were categorized in 2 groups according to the age at the time of diagnosis: <60 years (N = 363) and ≥60 years (N = 74). Moreover, an elderly patients' subgroup analysis was performed between patients with an age between 60 and 70 years (N = 49) and subjects older than 70 years (N = 25). Among elderly patients (50% male, mean age: 67 ± 6 years), family history of sudden death (SD) and induction of sustained ventricular arrhythmias during programmed ventricular stimulation were less frequent as compared to younger patients. Two patients (3%) had a previous episode of aborted SD. Elderly patients with BS presented more frequently with ECG conduction disturbances or previous transient advanced atrioventricular block as compared to younger patients. Of the elderly patients, 42% underwent implantable cardioverter defibrillator implantation and 7% received a pacemaker. After a mean follow-up time of 54 ± 18 months, none of the elderly patients with BS older than 70 years experienced documented life-threating ventricular arrhythmias. Family screening was performed in 58 family members and a BS diagnosis was confirmed in 49%.
  
  
  CONCLUSIONS
  The clinical features and the benign prognosis of BS patients older than 70 years likely identify a lower risk category of patients as compared to younger individuals. The device-guided management in this setting remains individualized and sometimes controversial. Moreover, BS diagnosis in the elderly should not be missed, mainly due to the clinical impact on the family of elderly patients.
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Giulio
authors.initials: G
authors.lastname: Conte
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Carlo
authors.initials: C
authors.lastname: DE Asmundis
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Juan
authors.initials: J
authors.lastname: Sieira
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Moises
authors.initials: M
authors.lastname: Levinstein
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Gian-Battista
authors.initials: GB
authors.lastname: Chierchia
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Giacomo
authors.initials: G
authors.lastname: DI Giovanni
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Giannis
authors.initials: G
authors.lastname: Baltogiannis
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ciconte
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Saitoh
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Ruben
authors.initials: R
authors.lastname: Casado-Arroyo
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Gudrun
authors.initials: G
authors.lastname: Pappaert
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Pedro
authors.initials: P
authors.lastname: Brugada
mesh_terms: D000367:Age Factors; D000368:Aged; D054537:Atrioventricular Block / Q000209:etiology / Q000628:therapy; D053840:Brugada Syndrome / Q000150:complications / Q000175:diagnosis* / Q000235:genetics / Q000503:physiopathology / Q000628:therapy*; D002304:Cardiac Pacing, Artificial; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000517:prevention & control; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000295:instrumentation; D004562:Electrocardiography; D005260:Female; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D010375:Pedigree; D011237:Predictive Value of Tests; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013575:Syncope / Q000209:etiology / Q000628:therapy; D013997:Time Factors
keywords: Brugada syndrome; ajmaline; elderly; sudden death