Abstract 13584: Can Family History of Sudden Death Predict a Risk for Ventricular Fibrillation in Patients With Brugada Syndrome?
Introduction: Some reports showed that plural number of patients within a family of the Brugada syndrome (BrS) suffered from VF and family history (FH) of sudden death (SD) seems to be an important risk marker for VF. However, recent reports failed to show its predictive value for the occurrence of cardiac events in patients with BrS. Here, we evaluated incidence and situation of SD victims of the family member of the patients with BrS and examined its significance on subgroups of the patients.
Methods: We evaluated the incidence of FH of SD in 362 patients with BrS (246 asymptomatic patients [Asymptomatic group], 97 patients with syncope [Syncope group] and 19 patients with VF [VF group]). We analyzed situation and the potent risk factors at the setting of SD in victims.
Results: Ninety-eight patients with BrS (27%) had 126 victims of SD in their families (111 males, age at SD 48 ± 11yrs.). Incidence of FH of SD was not different in each patient subgroup (Asymptomatic: 27%, Syncope: 28%, VF: 21%). Most of the SD occurred at night or early morning (69%), especially during sleeping (36%) or after alcohol drinking (12%). These situations of SD were similar to that of initial VF attacks in patients diagnosed as BrS.
ROC analysis determined that the cutoff value of FH of SD at age < 48 yrs. in patients with BrS and VF events. FH of SD < 48 yrs. was observed in 62 patients (17%). Patients with FH of SD < 48 yrs. had more frequent incidences of SCN5A mutation (31% vs. no FH 11%, p=0.004) and inferolateral early repolarization (32% vs. no FH 21%, p=0.036) than patients without FH. During follow-up (88 ± 50 months), 7 patients in Asymptomatic, 17 patients in Syncope and 12 patients in VF groups were suffered from VF attack. FH of SD < 48 yrs. predicted shorter time to experience VF episodes during follow-up periods in overall patients, especially in patients with syncope (cardiac event rate/year in Syncope group: patients with FH <48 yrs. : 7.0 %/yr., patients without FH: 1.7 %/yr., p=0.0016) and it was a predictor of prognosis in patients with syncope (hazard ratio: 4.11, 95% confidence interval 1.54 - 10.77, p=0.006).
Conclusions: FH of SD < 48 yrs. was a predictor of prognosis in BrS patients with syncope episodes. Evaluation of the FH is an important tool for risk stratification in patients with BrS.
Author Disclosures: H. Morita: Other; Modest; Affiliation with Endowed Department: (Japan Medtronic Inc). S. Nagase: None. H. Nishii: None. K. Nakagawa: None. A. Ueoka: None. A. Miyoshi: None. M. Kubo: None. H. Ito: None.
- © 2014 by American Heart Association, Inc.