학술논문
Brugada syndrome and syncope: A systematic review.
Document Type
Academic Journal
Author
Mascia G; CardioThoracoVascular Department, Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy.; Della Bona R; CardioThoracoVascular Department, Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy.; Ameri P; CardioThoracoVascular Department, Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy.; Department of Internal Medicine, University of Genoa, Genoa, Italy.; Canepa M; CardioThoracoVascular Department, Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy.; Department of Internal Medicine, University of Genoa, Genoa, Italy.; Porto I; CardioThoracoVascular Department, Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy.; Department of Internal Medicine, University of Genoa, Genoa, Italy.; Brignole M; Faint and Fall Program, Ospedale San Luca, IRCCS Istituto Auxologico Italiano, Milan, Italy.
Source
Publisher: Blackwell Country of Publication: United States NLM ID: 9010756 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1540-8167 (Electronic) Linking ISSN: 10453873 NLM ISO Abbreviation: J Cardiovasc Electrophysiol Subsets: MEDLINE
Subject
Language
English
Abstract
Introduction: Distinguishing syncope due to malignant arrhythmias from an incidental benign form in Brugada syndrome (BrS) is often difficult. Through systematic literature review, we evaluated the role of syncope in predicting subsequent malignant arrhythmias in BrS.
Methods: A comprehensive literature search was performed on PubMed (MeSH search terms "Brugada syndrome" and "syncope"). Overall, 9 studies for a total of 1347 patients were included. Patients were stratified as affected by suspected arrhythmic syncope (SAS), undefined syncope (US) or neurally-mediated syncope (NMS).
Results: Overall, 15.7% of the 279 patients with SAS had malignant arrhythmic events during a mean follow-up of 67 months, corresponding to 2.8 events per 100/person year. At the same time, 7% of the 527 patients affected by US had malignant arrhythmias during a mean follow-up of 39 months, corresponding 2.2 events per 100/person year. Conversely, 0.7% of 541 patients with NMS had malignant arrhythmic events at follow-up, corresponding to 0.13 events per 100/person year (p = .0001 NMS versus SAS and US pooled).
Conclusion: In BrS population, the risk of arrhythmic events in the follow-up may be stratified according to the clinical evaluation. The "relatively" low predictive value of the clinical diagnosis of SAS warrants for a more accurate multi-parametric assessment, to restrict the number of candidates for implantable cardioverter-defibrillator therapy.
(© 2020 Wiley Periodicals LLC.)
Methods: A comprehensive literature search was performed on PubMed (MeSH search terms "Brugada syndrome" and "syncope"). Overall, 9 studies for a total of 1347 patients were included. Patients were stratified as affected by suspected arrhythmic syncope (SAS), undefined syncope (US) or neurally-mediated syncope (NMS).
Results: Overall, 15.7% of the 279 patients with SAS had malignant arrhythmic events during a mean follow-up of 67 months, corresponding to 2.8 events per 100/person year. At the same time, 7% of the 527 patients affected by US had malignant arrhythmias during a mean follow-up of 39 months, corresponding 2.2 events per 100/person year. Conversely, 0.7% of 541 patients with NMS had malignant arrhythmic events at follow-up, corresponding to 0.13 events per 100/person year (p = .0001 NMS versus SAS and US pooled).
Conclusion: In BrS population, the risk of arrhythmic events in the follow-up may be stratified according to the clinical evaluation. The "relatively" low predictive value of the clinical diagnosis of SAS warrants for a more accurate multi-parametric assessment, to restrict the number of candidates for implantable cardioverter-defibrillator therapy.
(© 2020 Wiley Periodicals LLC.)