Abstract 10898: Seasonal and Circadian Distribution of Ventricular Fibrillation in Patients with Early Repolarization Syndrome: SCARE registry
Background: Several studies reported that coronary death and cardiac arrest occurred more often in winter morning in patients with structural heart disease. In contrast, it isknown that ventricular fibrillation (VF) in Brugada syndrome occurs more frequently during nighttime and from spring to early summer. The aim of this study was to investigate whether early repolarization syndrome (ERS) has a seasonal and circadian distribution of VF similar to Brugada syndrome enrolled in The Sudden Cardiac Arrest Associated with Repolarization Abnormality (SCARE) registry.
Methods and Results: ERS was defined as a QRS-ST junction elevation of ≥ 0.1mV with terminal QRS slurring or notching in at least 2 contiguous inferior and/or lateral leads, and associated with at least one episode of cardiac arrest or syncope. Patients were excluded if the patients had Brugada syndrome, long- or short- QT syndrome or catecholaminergic polymorphic VT. The follow-up data from implantable cardioverter-defibrillators (ICDs) were obtained in all cases. We evaluated all events of cardiac arrest, syncope and appropriate ICD shock therapies in patients with ERS. Among 23 consecutive patients with ERS (age; 40±17 years, 19 males), 57 events were evaluated during a mean follow-up of 43±41 months. The most frequent episodes of VF occurred in winter, and on the other hand, the episodes of VF occurred similarly in spring, summer and autumn. In addition, the ICD events may have had a correlation to the atmospheric air pressure, and an inverse correlation to the temperature of Tokyo, and the number of events tended to increase or decrease with the seasonal change. The time of the onset was available in 53 events. The circadian distribution of VF statistically differed between the four 6-hour periods, and there was a significant peak from midnight to 6:00. (0:00-6:00: 36 events [68%], 6:00-12:00: 5 events [9%], 12:00-18:00: 7 events [13%], 18:00-24:00: 5 events [9%]; P < 0.01). Similarly, as for the first episode, there was a significant peak from midnight to 6:00 (P < 0.01).
Conclusion: In patients with ERS, VF occurred more frequently during the nighttime as observed in Brugada syndrome, but the seasonal distribution of VF different from that of Brugada syndrome.
- © 2012 by American Heart Association, Inc.