Ethnic differences in patients with Brugada syndrome and arrhythmic events: New insights from Survey on Arrhythmic Events in Brugada Syndrome
Journal
Heart Rhythm
Journal Volume
16
Journal Issue
10
Pages
1468-1474
Date Issued
2019
Author(s)
Milman A.
Andorin A.
Postema P.G.
Gourraud J.-B.
Sacher F.
Mabo P.
Kim S.-H.
Maeda S.
Takahashi Y.
Kamakura T.
Aiba T.
Conte G.
Leshem E.
Michowitz Y.
Fogelman R.
Hochstadt A.
Mizusawa Y.
Giustetto C.
Arbelo E.
Huang Z.
Corrado D.
Delise P.
Allocca G.
Takagi M.
Wijeyeratne Y.D.
Mazzanti A.
Brugada R.
Casado-Arroyo R.
Champagne J.
Calo L.
Sarquella-Brugada G.
Jespersen C.H.
Tfelt-Hansen J.
Veltmann C.
Priori S.G.
Behr E.R.
Yan G.-X.
Brugada J.
Gaita F.
Wilde A.A.M.
Brugada P.
Kusano K.F.
Hirao K.
Nam G.-B.
Probst V.
Belhassen B.
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. ? 2019 Heart Rhythm Society
Subjects
Arrhythmic event; Asian; Brugada syndrome; SCN5A mutation; White
SDGs
Other Subjects
sodium channel Nav1.5; adult; aged; Article; Asian; Brugada syndrome; comparative study; ECG abnormality; electrocardiography; ethnic difference; ethnic group; faintness; family history; female; fever; gene mutation; genetic screening; genetic trait; health survey; heart arrest; heart arrhythmia; heart electrophysiology; heart ventricle arrhythmia; hospital patient; human; major clinical study; male; medical history; multicenter study; priority journal; sex ratio; sudden cardiac death; age distribution; Asian continental ancestry group; Brugada syndrome; Caucasian; clinical trial; comorbidity; cross-sectional study; diagnostic imaging; ethnology; genetics; heart arrhythmia; incidence; international cooperation; middle aged; onset age; procedures; prognosis; risk assessment; severity of illness index; Adult; Age Distribution; Age of Onset; Aged; Arrhythmias, Cardiac; Asian Continental Ancestry Group; Brugada Syndrome; Comorbidity; Cross-Sectional Studies; Death, Sudden, Cardiac; Electrocardiography; European Continental Ancestry Group; Female; Humans; Incidence; Internationality; Male; Middle Aged; Prognosis; Risk Assessment; Severity of Illness Index; Sex Distribution
Publisher
Elsevier B.V.
Type
journal article