Abstract
Aim: This study aims to describe prevalence and clinical significance of latent Brugada syndrome (BrS) in a young population with atrial fibrillation (AF).Methods: Between September 2015 and November 2017, among 111 AF patients below 45 years of age, those without pre-existing pathologies and/or known risk factors were selected for the study. Based on baseline 12-lead−24-h Holter electrocardiogram (ECG), previous class 1C antiarrhythmic drug therapy, or ajmaline testing, patients were stratified as latent type 1 BrS or not.Results: Within the 78 enrolled patients, 13 (16.7%; group 1) revealed a type 1 BrS ECG pattern, while 65 (83.3%; group 2) did not. Mean age was 37 ± 8 vs. 35 ± 7 (p = 0.42), and males were 7 (54%) vs. 54 (83%) (p = 0.02) in the two groups, respectively. Family history of BrS was significantly more common within group 1 patients (2, 15% vs. 0; p = 0.03), and 4 (31%) patients experienced syncope in group 1 vs. 5 (8%) in group 2 (p = 0.02). After a mean follow-up of 42 ± 18 months from the index AF event, more than 80% of the patients, in both study groups, were in sinus rhythm.Conclusion: In young patients with AF without pre-existing pathologies and/or known risk factors, latent BrS should be suspected. Syncope and a family history of BrS emerge as easily identifiable factors related to BrS. Long-term sinus rhythm maintenance appears satisfactory, either in the presence or not of BrS.
Highlights
Brugada syndrome (BrS) is a genetic disease that accounts for ∼20% of sudden cardiac death (SCD) cases in young, healthy adults with structurally normal hearts [1]
The aim of the present study is to evaluate prevalence and influence on clinical management and outcomes of latent BrS in young patients with atrial fibrillation (AF) without pre-existing pathologies and/or known risk factors
The diagnosis of a BrS ECG pattern was established according to the criteria of the second consensus conference [1] and according to the expert consensus statement of the Heart Rhythm Society, European Heart Rhythm Association (EHRA), and Asia Pacific Heart Rhythm Society (APHRS) in 2013 [6]
Summary
Brugada syndrome (BrS) is a genetic disease that accounts for ∼20% of sudden cardiac death (SCD) cases in young, healthy adults with structurally normal hearts [1]. Latent Brugada and Atrial Fibrillation precordial lead positioned at the second, third, or fourth intercostal spaces, either spontaneously or after provocation by intravenous (IV) administration of class 1 antiarrhythmic drugs (AADs). 20% of patients with BrS develop supraventricular arrhythmias—most commonly atrial fibrillation (AF) [2]. The incidence of AF in patients with BrS has been reported to vary from 11 to 39% [3] and is considered to be an index of poor prognosis. Latent BrS has been reported in patients with new-onset AF [3,4,5]
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