Ethnic differences in patients with Brugada syndrome and arrhythmic events: New insights from Survey on Arrhythmic Events in Brugada Syndrome.

Abstract

BACKGROUND:

There is limited information on ethnic differences between patients with Brugada syndrome (BrS) and arrhythmic events (AEs).

OBJECTIVE:

The purpose of this study was to compare clinical, electrocardiographic (ECG), electrophysiological, and genetic characteristics between white and Asian patients with BrS and AEs.

METHODS:

The Survey on Arrhythmic Events in Brugada Syndrome is a multicenter survey from Western and Asian countries, gathering 678 patients with BrS and first documented AE. After excluding patients with other (n = 14 [2.1%]) or unknown (n = 30 [4.4%]) ethnicity, 364 (53.7%) whites and 270 (39.8%) Asians comprised the study group.

RESULTS:

There was no difference in AE age onset (41.3 ± 16.1 years in whites vs 43.3 ± 12.3 years in Asians; P = .285). Higher proportions of whites were observed in pediatric and elderly populations. Asians were predominantly men (98.1% vs 85.7% in whites; P < .001) and frequently presented with aborted cardiac arrest (71.1% vs 56%; P < .001). Asians tended to display more spontaneous type 1 BrS-ECG pattern (71.5% vs 64.3%; P = .068). A family history of sudden cardiac death was noted more in whites (29.1% vs 11.5%; P < .001), with a higher rate of SCN5A mutation carriers (40.1% vs 13.2% in Asians; P < .001), as well as more fever-related AEs (8.5% vs 2.9%; P = .011). No difference was observed between the 2 groups regarding history of syncope and ventricular arrhythmia inducibility.

CONCLUSION:

There are important differences between Asian and white patients with BrS. Asian patients present almost exclusively as male adults, more often with aborted cardiac arrest and spontaneous type 1 BrS-ECG. However, they have less family history of sudden cardiac death and markedly lower SCN5A mutation rates. The striking difference in SCN5A mutation rates should be tested in future studies.

• Authors: Anat Milman, Antoine Andorin, Pieter G Postema, Jean-Baptiste Gourraud, Frederic Sacher, Philippe Mabo, Sung-Hwan Kim, Shingo Maeda, Yoshihide Takahashi, Tsukasa Kamakura, Takeshi Aiba, Giulio Conte, Jimmy J M Juang, Eran Leshem, Yoav Michowitz, Rami Fogelman, Aviram Hochstadt, Yuka Mizusawa, Carla Giustetto, Elena Arbelo, Zhengrong Huang, Domenico Corrado, Pietro Delise, Giuseppe Allocca, Masahiko Takagi, Yanushi D Wijeyeratne, Andrea Mazzanti, Ramon Brugada, Ruben Casado-Arroyo, Jean Champagne, Leonardo Calo, Georgia Sarquella-Brugada, Camilla H Jespersen, Jacob Tfelt-Hansen, Christian Veltmann, Silvia G Priori, Elijah R Behr, Gan-Xin Yan, Josep Brugada, Fiorenzo Gaita, Arthur A M Wilde, Pedro Brugada, Kengo F Kusano, Kenzo Hirao, Gi-Byoung Nam, Vincent Probst, Bernard Belhassen
• Journal: Heart rhythm (Heart Rhythm) Vol. 16 Issue 10 Pg. 1468-1474 (10 2019) ISSN: 1556-3871 [Electronic] United States
• PMID: 31284050 (Publication Type: Comparative Study, Journal Article, Multicenter Study)
• Copyright: Copyright © 2019 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Topics

• Adult
• Age Distribution
• Age of Onset
• Aged
• Arrhythmias, Cardiac (diagnostic imaging, ethnology)
• Asian People (genetics, statistics & numerical data)
• Brugada Syndrome (diagnostic imaging, ethnology)
• Comorbidity
• Cross-Sectional Studies
• Death, Sudden, Cardiac (ethnology)
• Electrocardiography (methods)
• Female
• Humans
• Incidence
• Internationality
• Male
• Middle Aged
• Prognosis
• Risk Assessment
• Severity of Illness Index
• Sex Distribution
• White People (genetics, statistics & numerical data)