Risk Stratification in Patients With Brugada Syndrome Without Previous Cardiac Arrest: Prognostic Value of Combined Risk Factors
Background:Risk stratification in patients with Brugada syndrome for primary prevention of sudden cardiac death is still an unsettled issue. A recent consensus statement suggested the indication of implantable cardioverter defibrillator (ICD) depending on the clinical risk factors present (spontaneo...
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| Veröffentlicht in: | Circulation Journal 2015/01/23, Vol.79(2), pp.310-317 |
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| creator | Okamura, Hideo Kamakura, Tsukasa Morita, Hiroshi Tokioka, Koji Nakajima, Ikutaro Wada, Mitsuru Ishibashi, Kohei Miyamoto, Koji Noda, Takashi Aiba, Takeshi Nishii, Nobuhiro Nagase, Satoshi Shimizu, Wataru Yasuda, Satoshi Ogawa, Hisao Kamakura, Shiro Ito, Hiroshi Ohe, Tohru Kusano, Kengo F. |
| description | Background:Risk stratification in patients with Brugada syndrome for primary prevention of sudden cardiac death is still an unsettled issue. A recent consensus statement suggested the indication of implantable cardioverter defibrillator (ICD) depending on the clinical risk factors present (spontaneous type 1 Brugada electrocardiogram (ECG) [Sp1], history of syncope [syncope], and ventricular fibrillation during programmed electrical stimulation [PES+]). The indication of ICD for the majority of patients, however, remains unclear.Methods and Results:A total of 218 consecutive patients (211 male; aged 46±13 years) with a type 1 Brugada ECG without a history of cardiac arrest who underwent evaluation for ICD including electrophysiological testing were examined retrospectively. During a mean follow-up period of 78 months, 26 patients (12%) developed arrhythmic events. On Kaplan-Meier analysis patients with each of Sp1, syncope, or PES+ suffered arrhythmic events more frequently (P=0.018, P |
| doi_str_mv | 10.1253/circj.CJ-14-1059 |
| format | Article |
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A recent consensus statement suggested the indication of implantable cardioverter defibrillator (ICD) depending on the clinical risk factors present (spontaneous type 1 Brugada electrocardiogram (ECG) [Sp1], history of syncope [syncope], and ventricular fibrillation during programmed electrical stimulation [PES+]). The indication of ICD for the majority of patients, however, remains unclear.Methods and Results:A total of 218 consecutive patients (211 male; aged 46±13 years) with a type 1 Brugada ECG without a history of cardiac arrest who underwent evaluation for ICD including electrophysiological testing were examined retrospectively. During a mean follow-up period of 78 months, 26 patients (12%) developed arrhythmic events. On Kaplan-Meier analysis patients with each of Sp1, syncope, or PES+ suffered arrhythmic events more frequently (P=0.018, P<0.001, and P=0.003, respectively). On multivariate analysis Sp1 and syncope were independent predictors of arrhythmic events. When dividing patients according to the number of these 3 risk factors present, patients with 2 or 3 risk factors experienced arrhythmic events more frequently than those with 0 or 1 risk factor (23/93 vs. 3/125; P<0.001).Conclusions:Syncope, Sp1, and PES+ are important risk factors and the combination of these risks well stratify the risk of later arrhythmic events. (Circ J 2015; 79: 310–317)</description><identifier>ISSN: 1346-9843</identifier><identifier>EISSN: 1347-4820</identifier><identifier>DOI: 10.1253/circj.CJ-14-1059</identifier><identifier>PMID: 25428522</identifier><language>eng</language><publisher>Japan: The Japanese Circulation Society</publisher><subject>Adult ; Brugada syndrome ; Brugada Syndrome - complications ; Brugada Syndrome - diagnosis ; Brugada Syndrome - epidemiology ; Brugada Syndrome - physiopathology ; Electrocardiography ; Electrophysiological study ; Female ; Follow-Up Studies ; Heart Arrest ; Humans ; Male ; Middle Aged ; Primary prevention ; Prognosis ; Risk Assessment ; Risk Factors ; Risk stratification ; Syncope ; Syncope - diagnosis ; Syncope - epidemiology ; Syncope - etiology ; Syncope - physiopathology ; Ventricular Fibrillation - diagnosis ; Ventricular Fibrillation - epidemiology ; Ventricular Fibrillation - etiology ; Ventricular Fibrillation - physiopathology</subject><ispartof>Circulation Journal, 2015/01/23, Vol.79(2), pp.310-317</ispartof><rights>2015 THE JAPANESE CIRCULATION SOCIETY</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c405t-390900f62743bcc710781badcaf1c0edb33e01c02e448c9f5fd5a944c6dec4693</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1877,4010,27900,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25428522$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Okamura, Hideo</creatorcontrib><creatorcontrib>Kamakura, Tsukasa</creatorcontrib><creatorcontrib>Morita, Hiroshi</creatorcontrib><creatorcontrib>Tokioka, Koji</creatorcontrib><creatorcontrib>Nakajima, Ikutaro</creatorcontrib><creatorcontrib>Wada, Mitsuru</creatorcontrib><creatorcontrib>Ishibashi, Kohei</creatorcontrib><creatorcontrib>Miyamoto, Koji</creatorcontrib><creatorcontrib>Noda, Takashi</creatorcontrib><creatorcontrib>Aiba, Takeshi</creatorcontrib><creatorcontrib>Nishii, Nobuhiro</creatorcontrib><creatorcontrib>Nagase, Satoshi</creatorcontrib><creatorcontrib>Shimizu, Wataru</creatorcontrib><creatorcontrib>Yasuda, Satoshi</creatorcontrib><creatorcontrib>Ogawa, Hisao</creatorcontrib><creatorcontrib>Kamakura, Shiro</creatorcontrib><creatorcontrib>Ito, Hiroshi</creatorcontrib><creatorcontrib>Ohe, Tohru</creatorcontrib><creatorcontrib>Kusano, Kengo F.</creatorcontrib><title>Risk Stratification in Patients With Brugada Syndrome Without Previous Cardiac Arrest: Prognostic Value of Combined Risk Factors</title><title>Circulation Journal</title><addtitle>Circ J</addtitle><description>Background:Risk stratification in patients with Brugada syndrome for primary prevention of sudden cardiac death is still an unsettled issue. A recent consensus statement suggested the indication of implantable cardioverter defibrillator (ICD) depending on the clinical risk factors present (spontaneous type 1 Brugada electrocardiogram (ECG) [Sp1], history of syncope [syncope], and ventricular fibrillation during programmed electrical stimulation [PES+]). The indication of ICD for the majority of patients, however, remains unclear.Methods and Results:A total of 218 consecutive patients (211 male; aged 46±13 years) with a type 1 Brugada ECG without a history of cardiac arrest who underwent evaluation for ICD including electrophysiological testing were examined retrospectively. During a mean follow-up period of 78 months, 26 patients (12%) developed arrhythmic events. On Kaplan-Meier analysis patients with each of Sp1, syncope, or PES+ suffered arrhythmic events more frequently (P=0.018, P<0.001, and P=0.003, respectively). On multivariate analysis Sp1 and syncope were independent predictors of arrhythmic events. When dividing patients according to the number of these 3 risk factors present, patients with 2 or 3 risk factors experienced arrhythmic events more frequently than those with 0 or 1 risk factor (23/93 vs. 3/125; P<0.001).Conclusions:Syncope, Sp1, and PES+ are important risk factors and the combination of these risks well stratify the risk of later arrhythmic events. (Circ J 2015; 79: 310–317)</description><subject>Adult</subject><subject>Brugada syndrome</subject><subject>Brugada Syndrome - complications</subject><subject>Brugada Syndrome - diagnosis</subject><subject>Brugada Syndrome - epidemiology</subject><subject>Brugada Syndrome - physiopathology</subject><subject>Electrocardiography</subject><subject>Electrophysiological study</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Arrest</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Primary prevention</subject><subject>Prognosis</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Risk stratification</subject><subject>Syncope</subject><subject>Syncope - diagnosis</subject><subject>Syncope - epidemiology</subject><subject>Syncope - etiology</subject><subject>Syncope - physiopathology</subject><subject>Ventricular Fibrillation - diagnosis</subject><subject>Ventricular Fibrillation - epidemiology</subject><subject>Ventricular Fibrillation - etiology</subject><subject>Ventricular Fibrillation - physiopathology</subject><issn>1346-9843</issn><issn>1347-4820</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkMtPAjEQxhujEUTvnkyPXhb72kePuBGVkEhE4rEp3S4U94Ft14T_3l1Aucx8mfzmm8kHwC1GQ0xC-qCMVZthOgkwCzAK-RnoY8rigCUEne91FPCE0R64cm6DEOEtdAl6JGQkCQnpg8W7cV9w7q30JjeqrXUFTQVnrdKVd_DT-DV8tM1KZhLOd1Vm61Lvp3Xj4czqH1M3DqbSZkYqOLJWO38NLnJZOH1z7AOwGD99pC_B9O35NR1NA8VQ6APKEUcoj0jM6FKpGKM4wUuZKZljhXS2pFSjVhHNWKJ4HuZZKDljKsq0YhGnA3B_8N3a-rtpD4vSOKWLQla6_UrgKMKUUkI7FB1QZWvnrM7F1ppS2p3ASHRhin2YIp0IzEQXZrtyd3RvlqXO_hf-0muB8QHYOC9X-h-Q1htV6KNjzAXpysn5BKylFbqiv8Oxivg</recordid><startdate>2015</startdate><enddate>2015</enddate><creator>Okamura, Hideo</creator><creator>Kamakura, Tsukasa</creator><creator>Morita, Hiroshi</creator><creator>Tokioka, Koji</creator><creator>Nakajima, Ikutaro</creator><creator>Wada, Mitsuru</creator><creator>Ishibashi, Kohei</creator><creator>Miyamoto, Koji</creator><creator>Noda, Takashi</creator><creator>Aiba, Takeshi</creator><creator>Nishii, Nobuhiro</creator><creator>Nagase, Satoshi</creator><creator>Shimizu, Wataru</creator><creator>Yasuda, Satoshi</creator><creator>Ogawa, Hisao</creator><creator>Kamakura, Shiro</creator><creator>Ito, Hiroshi</creator><creator>Ohe, Tohru</creator><creator>Kusano, Kengo F.</creator><general>The Japanese Circulation Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2015</creationdate><title>Risk Stratification in Patients With Brugada Syndrome Without Previous Cardiac Arrest</title><author>Okamura, Hideo ; Kamakura, Tsukasa ; Morita, Hiroshi ; Tokioka, Koji ; Nakajima, Ikutaro ; Wada, Mitsuru ; Ishibashi, Kohei ; Miyamoto, Koji ; Noda, Takashi ; Aiba, Takeshi ; Nishii, Nobuhiro ; Nagase, Satoshi ; Shimizu, Wataru ; Yasuda, Satoshi ; Ogawa, Hisao ; Kamakura, Shiro ; Ito, Hiroshi ; Ohe, Tohru ; Kusano, Kengo F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-390900f62743bcc710781badcaf1c0edb33e01c02e448c9f5fd5a944c6dec4693</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Brugada syndrome</topic><topic>Brugada Syndrome - complications</topic><topic>Brugada Syndrome - diagnosis</topic><topic>Brugada Syndrome - epidemiology</topic><topic>Brugada Syndrome - physiopathology</topic><topic>Electrocardiography</topic><topic>Electrophysiological study</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Arrest</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Primary prevention</topic><topic>Prognosis</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Risk stratification</topic><topic>Syncope</topic><topic>Syncope - diagnosis</topic><topic>Syncope - epidemiology</topic><topic>Syncope - etiology</topic><topic>Syncope - physiopathology</topic><topic>Ventricular Fibrillation - diagnosis</topic><topic>Ventricular Fibrillation - epidemiology</topic><topic>Ventricular Fibrillation - etiology</topic><topic>Ventricular Fibrillation - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Okamura, Hideo</creatorcontrib><creatorcontrib>Kamakura, Tsukasa</creatorcontrib><creatorcontrib>Morita, Hiroshi</creatorcontrib><creatorcontrib>Tokioka, Koji</creatorcontrib><creatorcontrib>Nakajima, Ikutaro</creatorcontrib><creatorcontrib>Wada, Mitsuru</creatorcontrib><creatorcontrib>Ishibashi, Kohei</creatorcontrib><creatorcontrib>Miyamoto, Koji</creatorcontrib><creatorcontrib>Noda, Takashi</creatorcontrib><creatorcontrib>Aiba, Takeshi</creatorcontrib><creatorcontrib>Nishii, Nobuhiro</creatorcontrib><creatorcontrib>Nagase, Satoshi</creatorcontrib><creatorcontrib>Shimizu, Wataru</creatorcontrib><creatorcontrib>Yasuda, Satoshi</creatorcontrib><creatorcontrib>Ogawa, Hisao</creatorcontrib><creatorcontrib>Kamakura, Shiro</creatorcontrib><creatorcontrib>Ito, Hiroshi</creatorcontrib><creatorcontrib>Ohe, Tohru</creatorcontrib><creatorcontrib>Kusano, Kengo F.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Okamura, Hideo</au><au>Kamakura, Tsukasa</au><au>Morita, Hiroshi</au><au>Tokioka, Koji</au><au>Nakajima, Ikutaro</au><au>Wada, Mitsuru</au><au>Ishibashi, Kohei</au><au>Miyamoto, Koji</au><au>Noda, Takashi</au><au>Aiba, Takeshi</au><au>Nishii, Nobuhiro</au><au>Nagase, Satoshi</au><au>Shimizu, Wataru</au><au>Yasuda, Satoshi</au><au>Ogawa, Hisao</au><au>Kamakura, Shiro</au><au>Ito, Hiroshi</au><au>Ohe, Tohru</au><au>Kusano, Kengo F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk Stratification in Patients With Brugada Syndrome Without Previous Cardiac Arrest: Prognostic Value of Combined Risk Factors</atitle><jtitle>Circulation Journal</jtitle><addtitle>Circ J</addtitle><date>2015</date><risdate>2015</risdate><volume>79</volume><issue>2</issue><spage>310</spage><epage>317</epage><pages>310-317</pages><issn>1346-9843</issn><eissn>1347-4820</eissn><abstract>Background:Risk stratification in patients with Brugada syndrome for primary prevention of sudden cardiac death is still an unsettled issue. A recent consensus statement suggested the indication of implantable cardioverter defibrillator (ICD) depending on the clinical risk factors present (spontaneous type 1 Brugada electrocardiogram (ECG) [Sp1], history of syncope [syncope], and ventricular fibrillation during programmed electrical stimulation [PES+]). The indication of ICD for the majority of patients, however, remains unclear.Methods and Results:A total of 218 consecutive patients (211 male; aged 46±13 years) with a type 1 Brugada ECG without a history of cardiac arrest who underwent evaluation for ICD including electrophysiological testing were examined retrospectively. During a mean follow-up period of 78 months, 26 patients (12%) developed arrhythmic events. On Kaplan-Meier analysis patients with each of Sp1, syncope, or PES+ suffered arrhythmic events more frequently (P=0.018, P<0.001, and P=0.003, respectively). On multivariate analysis Sp1 and syncope were independent predictors of arrhythmic events. When dividing patients according to the number of these 3 risk factors present, patients with 2 or 3 risk factors experienced arrhythmic events more frequently than those with 0 or 1 risk factor (23/93 vs. 3/125; P<0.001).Conclusions:Syncope, Sp1, and PES+ are important risk factors and the combination of these risks well stratify the risk of later arrhythmic events. (Circ J 2015; 79: 310–317)</abstract><cop>Japan</cop><pub>The Japanese Circulation Society</pub><pmid>25428522</pmid><doi>10.1253/circj.CJ-14-1059</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Brugada syndrome Brugada Syndrome - complications Brugada Syndrome - diagnosis Brugada Syndrome - epidemiology Brugada Syndrome - physiopathology Electrocardiography Electrophysiological study Female Follow-Up Studies Heart Arrest Humans Male Middle Aged Primary prevention Prognosis Risk Assessment Risk Factors Risk stratification Syncope Syncope - diagnosis Syncope - epidemiology Syncope - etiology Syncope - physiopathology Ventricular Fibrillation - diagnosis Ventricular Fibrillation - epidemiology Ventricular Fibrillation - etiology Ventricular Fibrillation - physiopathology |
| title | Risk Stratification in Patients With Brugada Syndrome Without Previous Cardiac Arrest: Prognostic Value of Combined Risk Factors |
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