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Abstract

Aims

We sought to investigate the value of a family history of sudden death (SD) in Brugada syndrome (BS).

Methods and results

Two hundred and eighty consecutive patients (mean age: 41 ± 18 years, 168 males) with diagnostic type I Brugada ECG pattern were included. Sudden death occurred in 69 (43%) of 157 families. One hundred and ten SDs were analysed. During follow-up VF (ventricular fibrillation) or SD-free survival rate was not different between patients with or without a family history of SD of a first-degree relative, between patients with or without a family history of multiple SD of a first-degree relative at any age and between patients with or without a family history of SD in first-degree relatives ≤35 years. One patient had family history of SD of two first-degree relative ≤35 years with arrhythmic event during follow-up. In univariate analysis male gender (P = 0.01), aborted SD (P < 0.001), syncope (P = 0.04), spontaneous type I ECG (P < 0.001), and inducibility during electrophysiological (EP) study (P < 0.001) were associated with worse prognosis. The absence of syncope, aborted SD, spontaneous type I ECG, and inducibility during EP study was associated with a significantly better prognosis (P < 0.001).

Conclusion

Family history of SD is not predictive for future arrhythmic events even if considering only SD in first-degree relatives or SD in first-degree relatives at a young age. The absence of syncope, aborted SD, spontaneous type I ECG, and inducibility during EP study is associated with a good five-year prognosis.

Sudden death, Family history, Brugada syndrome
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2011. For permissions please email: [email protected]
Topic:
Issue Section:
Clinical Research > Arrhythmia/electrophysiology
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Comments

1 Comment
Comments (1)
Questions about Brugada Syndrome Article Eur Heart Journal July 4 2011
18 October 2011
Oscar Leonel Rueda-Ochoa
Internal medicine Physician - clinical Epidemiology, Professor Universidad Industrial de Santander

Dr. Sarkozy, I had read your interesting article about Brugada Syndrome published in Eur. Heart Journal July 4th 2011. I had doubts in relation with this sentence that you write: "Based on our results, we can reassure these patients that unless they have multiple first-degree relatives who died suddenly ?35 years of age, the SD in their family on medium term does not indicate a higher risk".

I think the authors can't affirm that, because the study doesn't have enough power to compare risk between persons with BS and family history of SD vs persons with BS and without family history of SD.

I had calculated the power using the next data (Table No.2):

No exposed (with family history)= 149 No. Non-exposed(without familyhistory)=131

% risk of outcome (SD)in exposed = 3.4% % risk of outcome (SD) in nonexposed= 6.9%

using www.openepi.com<http://www.openepi.com> for power calculate in cohort study you can find:

Power normal aproximation 26.58% power with continuity correction: 17.45%

Conclusion: This is an under-power study which can't show differences between both groups under comparison. (Type II error).

I would appreciate so much if you can give me answer to this question.

Submitted on 18/10/2011 8:00 PM GMT