Newly Diagnosed Brugada Syndrome Have a Different Prognosis Interview with:
Ruben Casado-Arroyo, MD, PhD
Heart Rhythm Management Center
Cardiovascular Division, UZ Brussel–Vrije Universiteit Brussel,
Cardiology Department, Arrhythmia Section
Erasmus Hospital, Université Libre de Bruxelles
Brussels, Belgium What is the background for this study? What are the main findings?

Response: The objective of this study is to evaluate the evolution of the
presentation of Brugada Syndrome (BrS) during the last 30 years. Only
the first diagnosed patient of each family was included. The database
was divided in two periods (early and latter group) in relation to the
consensus conference of 2002.

Aborted sudden death as the first manifestation of the disease
occurred most frequently in the earlier period 12.1% versus 4.6% of
the latter group. Inducibility (induction of ventricular fibrillation)
during programmed electrical stimulation was achieved in 34.4%
(earlier) and 19.2% (latter) of patients, respectively. A spontaneous
type 1 electrocardiogram pattern that is a coved type ST elevation
with at least 2 mm (0.2 mV) J-point elevation a gradually descending
ST segment followed by a negative T-wave was presented at diagnosis
50.3% (earlier) versus 26.2% (latter patients). Early group patients
had a higher probability of a recurrent arrhythmia (sudden cardiac
death or ventricular arrhythmias) during follow-up (19%) than those
of the latter group (5%). All these difference were significative.

Overall, the predictors of recurrent arrhythmias were previous sudden
cardiac death and inducibility. In the latter period, only previous
sudden cardiac death was a predictor of arrhythmic events. What should readers take away from your report?

Response: The presentation of BrS has changed. There has been a decrease in
aborted sudden cardiac death as the first manifestation of the disease
among patients who were more recently diagnosed. The value of
inducibility in this new era of Brugada Syndrome should be assessed. What recommendations do you have for future research as a result of this study?

Response: Further evaluation should be done to analyse the presentation and the
risk of BrS in this new period, with more patients diagnose, but with
a lower risk. Thank you for your contribution to the community.

Casado-Arroyo R, Berne P, Rao J, et al. Long-Term Trends in Newly Diagnosed Brugada Syndrome: Implications for Risk Stratification. J Am Coll Cardiol. 2016;68(6):614-623. doi:10.1016/j.jacc.2016.05.073.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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