title: Clinical characterisation and long-term prognosis of women with Brugada syndrome.
abstract: OBJECTIVE
  Brugada syndrome (BS) in women is considered an infrequent condition with a more favourable prognosis than in men. Nevertheless, arrhythmic events and sudden cardiac death (SCD) also occur in this population. Long-term follow-up data of this group are sparse. The purpose of the present study was to investigate the clinical characteristics and long-term prognosis of women with BS.
  
  
  METHODS
  A consecutive cohort of 228 women presenting with spontaneous or drug-induced Brugada type I ECG at our institution were included and compared with 314 men with the same diagnosis.
  
  
  RESULTS
  Mean age was 41.5±17.3 years. Clinical presentation was SCD in 6 (2.6%), syncope in 51 (22.4%) and the remaining 171 (75.0%) were asymptomatic. As compared with men, spontaneous type I ECG was less common (7.9% vs 23.2%, p<0.01) and less ventricular arrhythmias were induced during programmed electrical stimulation (5.5% vs 22.3%, p<0.01). An implantable cardioverter defibrillator (ICD) was implanted in 64 women (28.1%). During a mean follow-up of 73.2±56.2 months, seven patients developed arrhythmic events, constituting an event rate of 0.7% per year (as compared with 1.9% per year in men, p=0.02). Presentation as SCD or sinus node dysfunction (SND) was risk factor significantly associated with arrhythmic events (hazard risk (HR) 25.4 and 9.1).
  
  
  CONCLUSIONS
  BS is common in women, representing 42% of patients in our database. Clinical presentation is less severe than men, with more asymptomatic status and less spontaneous type I ECG and prognosis is more favourable, with an event rate of 0.7% year. However, women with SCD or previous SND are at higher risk of arrhythmic events.
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: Giulio
authors.initials: G
authors.lastname: Conte
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: Carlo
authors.initials: C
authors.lastname: de Asmundis
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: Giannis
authors.initials: G
authors.lastname: Baltogiannis
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: Yukio
authors.initials: Y
authors.lastname: Saitoh
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Ghazala
authors.initials: G
authors.lastname: Irfan
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: Justo
authors.initials: J
authors.lastname: Juliá
authors.affiliation: Cardiac Surgery Department, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Mark
authors.initials: M
authors.lastname: La Meir
authors.affiliation: Cardiac Surgery Department, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Francis
authors.initials: F
authors.lastname: Wellens
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Kristel
authors.initials: K
authors.lastname: Wauters
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: D000293:Adolescent; D000328:Adult; D000368:Aged; D000404:Ajmaline / Q000008:administration & dosage; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage; D001530:Belgium / Q000453:epidemiology; D053840:Brugada Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012737:Sex Factors; D015996:Survival Rate / Q000639:trends; D055815:Young Adult
chemical_list: D000889:Anti-Arrhythmia Agents; D000404:Ajmaline