title: Brugada syndrome in the young: an assessment of risk factors predicting future events.
abstract: OBJECTIVE
  To investigate the clinical characteristics, prognoses, and presence of risk factors in young patients with Brugada syndrome (BS).
  
  
  RESULTS
  A consecutive cohort of 128 young BS patients (≤25 years old at diagnosis) was analysed. Eighty-eight patients (69%) were asymptomatic, whereas 40 (31%) presented with clinical manifestations of BS. Markers of prognosis and risk were identified upon comparison of these two groups. A history of malignant syncope was strong predictors of ventricular arrhythmic events. Family history of sudden cardiac death (SCD) and mutations in the SCN5A gene did not associate with increased risk. Symptomatic patients presented with significantly abnormal baseline electrical characteristics when compared with the asymptomatic cohort, including spontaneous type I electrocardiograph (ECG) patterns, sinus node dysfunction (SND), first-degree atrioventricular (AV) block, and intra-ventricular conduction delay. The symptomatic group more frequently exhibited atrial arrhythmias. Electrophysiological studies resulted positive more frequently in symptomatic patients, but no risk association for future events could be determined. During the follow-up period (mean: 65 months), 10 arrhythmic events occurred in nine symptomatic patients (event rate: 4.5% per year). No events occurred in the asymptomatic group. Variables significantly associated with arrhythmic events during follow-up were presence of symptoms at diagnosis and spontaneous type I ECG. The presence of atrial arrhythmias and conduction abnormalities was also associated with the risk of arrhythmic events during follow-up.
  
  
  CONCLUSIONS
  Symptomatic BS in the young age is a rare but malignant condition that can manifest with a spectrum of electrical abnormalities (i.e. SND, atrial tachycardias, AV block, and infra-nodal conduction delay) and result in the extreme cases in lethal arrhythmic events and SCD.
authors.affiliation: Division of Pediatric Cardiology, Department of Pediatrics, Cliniques Universitaires Saint-Luc, 10 Avenue Hippocrate, 1200 Brussels, Belgium.|Department of Cardiology, University Hospital of Antwerp, Antwerp, Belgium.
authors.forename: Maria Cecilia
authors.initials: MC
authors.lastname: Gonzalez Corcia
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Juan
authors.initials: J
authors.lastname: Sieira
authors.affiliation: Department of Cardiology, University Hospital of Antwerp, Antwerp, Belgium.
authors.forename: Andrea
authors.initials: A
authors.lastname: Sarkozy
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: Jaime
authors.initials: J
authors.lastname: Hernandez Ojeda
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: D000200:Action Potentials; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D058070:Asymptomatic Diseases; D053840:Brugada Syndrome / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D017147:Defibrillators, Implantable; D018450:Disease Progression; D018572:Disease-Free Survival; D004554:Electric Countershock / Q000295:instrumentation; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D020022:Genetic Predisposition to Disease; D006329:Heart Conduction System / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
keywords: Brugada syndrome; Clinical characterization; Risk stratification