Long-term clinical outcomes of patients with drug-induced type 1 Brugada electrocardiographic pattern: A nationwide cohort registry study.

Autor:	Russo V; Division of Cardiology, Department of Medical Translational Sciences University of Campania 'Luigi Vanvitelli', Naples, Italy. Electronic address: vincenzo.russo@unicampania.it., Caturano A; Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy; Department of Experimental Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy., Migliore F; Università degli Studi di Padova, Padua, Italy., Guerra F; Azienda Ospedaliera Universitaria Ospedali Riuniti Ancona, Ancona, Italy., Francia P; Azienda Ospedaliero-Universitaria Sant'Andrea, Rome, Italy., Nesti M; Cardiovascular and Neurological Department, Ospedale San Donato, Arezzo, Italy., Conte G; Cardiocentro Ticino Foundation, Lugano, Switzerland., Perini AP; Azienda Sanitaria di Firenze, Florence, Italy., Mascia G; IRCCS San Martino Polyclinic Hospital, Genoa, Italy., Albani S; Umberto Parini Regional Hospital, Aosta, Italy., Marchese P; Ospedale Mazzoni, Ascoli Piceno, Italy., Santobuono VE; Cardiology Unit, Department of Interdisciplinary Medicine and Policlinico of Bari, University of Bari 'Aldo Moro', Bari, Italy., Dendramis G; Cardiology Unit, Clinical and Interventional Arrhythmology, ARNAS, Ospedale Civico Di Cristina Benfratelli, Palermo, Italy., Rossi A; Gabriele Monasterio Foundation, Pisa, Italy., Attena E; Ospedale V. Monaldi, Naples, Italy., Ghidini AO; Versilia Hospital, Cardiology Unit, Lido di Camaiore (LU), Italy., Sciarra L; Policlinico Casilino, Cardiology Unit, Rome, Italy., Palamà Z; Casa di Cura Villa Verde, Taranto, Italy., Baldi E; IRCCS Policlinico San Matteo, Pavia, Italy., Romeo E; Department of Cardiology, University of Campania 'Luigi Vanvitelli', Monaldi Hospital, Naples, Italy., D'Onofrio A; Monaldi Hospital, Departmental Unit of Electrophysiology, Evaluation and Treatment of Arrhythmias, Naples, Italy., Nigro G; Division of Cardiology, Department of Medical Translational Sciences University of Campania 'Luigi Vanvitelli', Naples, Italy.
Jazyk:	angličtina
Zdroj:	Heart rhythm [Heart Rhythm] 2024 May; Vol. 21 (5), pp. 555-561. Date of Electronic Publication: 2024 Jan 18.
DOI:	10.1016/j.hrthm.2024.01.015
Abstrakt:	Background: There are limited real-world data on the extended prognosis of patients with drug-induced type 1 Brugada electrocardiogram (ECG). Objective: We assessed the clinical outcomes and predictors of life-threatening arrhythmias in patients with drug-induced type 1 Brugada ECG. Methods: This multicenter retrospective study, conducted at 21 Italian and Swiss hospitals from July 1997 to May 2021, included consecutive patients with drug-induced type 1 ECG. The primary outcome, a composite of appropriate ICD therapies and sudden cardiac death, was assessed along with the clinical predictors of these events. Results: A total of 606 patients (mean age 49.7 ± 14.7 years; 423 [69.8%] men) were followed for a median of 60.3 months (interquartile range 23.0-122.4 months). Nineteen patients (3.1%) experienced life-threatening arrhythmias, with a median annual event rate of 0.5% over 5 years and 0.25% over 10 years. The SCN5A mutation was the only predictor of the primary outcome (hazard ratio 4.54; P = .002), whereas a trend was observed for unexplained syncope (hazard ratio 3.85; P = .05). In patients who were asymptomatic at presentation, the median annual rate of life-threatening arrhythmias is 0.24% over 5 years and increases to 1.2% if they have inducible ventricular fibrillation during programmed ventricular stimulation. Conclusion: In patients with drug-induced type 1 Brugada ECG, the annual risk of life-threatening arrhythmias is low, with the SCN5A mutation as the only independent predictor. Unexplained syncope correlated with worse clinical outcomes. Ventricular fibrillation inducibility at programmed ventricular stimulation significantly increases the median annual rate of life-threatening arrhythmias from 0.24% to 1.2% over 5 years. Competing Interests: Disclosures The authors have no conflicts of interest to disclose. (Copyright © 2024 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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