Abstract 16351: Arrhythmic Events in Brugada Syndrome: A Nation-Wide Israeli Survey of the Clinical Characteristics, Treatment and Long-Term Follow-Up (ISRABRU-VF)
Background: Since the first report on Brugada syndrome (BrS), only sparse information has been reported on the detailed characteristics and management of the small subset of patients who had an arrhythmic event (AE). We conducted the first nationwide comprehensive survey focused on the detailed clinical, diagnostic work up, electrophysiological (EP) characteristics and long term management of BrS patients who have had an AE.
Methods: All 21 Israeli EP units were invited to participate in the survey if they have treated patients with BrS who had suffered a cardiac arrest (CA) (lethal or aborted)(group 1) or experienced appropriate therapy for VF/VT events after prophylactic ICD implantation (group 2). Analysis included all eligible BrS patients.
Results: A total of 31 patients met the inclusion criteria from the entire country: 25 in group 1 and 6 in group 2. In group 1, 96% of patients were male; mean age at CA was 38 years (range 13-84). Nine (36%) patients presented with arrhythmic storm and 3 (12%) had a lethal outcome. A spontaneous type1 Brugada-ECG was observed in 17 (68%) of patients. EPS was performed in 11 (44%) patients with inducible VF in 10, that was prevented by quinidine in 7/8 patients reexamined on treatment. During follow up (143±119 months) 8 (32%) patients (who were not taking quinidine) experienced at least 1 appropriate shock and 5 patients received an inappropriate shock. At last follow-up visit, 18 (72%) patients had an active ICD while 11 (44%) were receiving quinidine (9 concomitant with ICD). Group 2 patients were all male, age 30-53 (mean 42), 4/6 patients had a family history of sudden death age<50. Five patients had spontaneous type 1 Brugada ECG and 4 were asymptomatic at ICD implantation. EPS was performed in 4 (66%) patients with inducible VF in 3 patients. During follow up (107±45 months) 5 patients received at least one appropriate shock and 1 had ATP for sustained VT (none while receiving quinidine). No AE re-occurred in patients subsequently treated with quinidine.
Conclusion: CA from BrS is a rare occurrence on a national scale and no AE occurred in any patient during treatment with quinidine. Discrepancies exist in the diagnostic workup and management of BrS following CA, and future guidelines should provide a framework for uniform evaluation.
Author Disclosures: E. Leshem: Other; Significant; NIH training grant 5T32HL007374-37. M. Rahkovich: None. A. Mazo: None. M. Suleiman: None. M. Blich: None. A. Laish-Farkash: None. Y. Konstantino: None. R. Fogelman: None. B. Strasberg: None. M. Geist: None. I. Chetboun: None. M. Swissa: None. M. Ilan: None. Y. Michowitz: None. R. Rosso: None. M. Glikson: None. B. Belhassen: None.
- © 2016 by American Heart Association, Inc.