Ethnic Differences in Patients with Brugada Syndrome and Arrhythmic Events: New insights from Survey on Arrhythmic Events in Brugada Syndrome

Anat Milman, Antoine Andorin, Pieter G Postema, Jean-Baptiste Gourraud, Frederic Sacher, Philippe Mabo, Sung-Hwan Kim, Shingo Maeda, Yoshihide Takahashi, Tsukasa Kamakura, Takeshi Aiba, Giulio Conte, Jimmy Jm Juang, Eran Leshem, Yoav Michowitz, Rami Fogelman, Aviram Hochstadt, Yuka Mizusawa, Carla Giustetto, Elena ArbeloZhengrong Huang, Domenico Corrado, Pietro Delise, Giuseppe Allocca, Masahiko Takagi, Yanushi D Wijeyeratne, Andrea Mazzanti, Ramon Brugada, Ruben Casado-Arroyo, Jean Champagne, Leonardo Calo, Georgia Sarquella-Brugada, Camilla H Jespersen, Jacob Tfelt-Hansen, Christian Veltmann, Silvia G Priori, Elijah R Behr, Gan-Xin Yan, Josep Brugada, Fiorenzo Gaita, Arthur A M Wilde, Pedro Brugada, Kengo F Kusano, Kenzo Hirao, Gi-Byoung Nam, Vincent Probst, Bernard Belhassen

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)

Abstract

BACKGROUND: There is limited information on ethnic differences between patients with Brugada syndrome (BrS) with arrhythmic events (AEs).

OBJECTIVES: To compare clinical, electrocardiographic (ECG), electrophysiologic (EP) and genetic characteristics between White and Asian BrS-patients with AE.

METHODS: SABRUS is a multicenter survey from Western and Asian countries, gathering 678 BrS-patients with 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=0.285). Higher proportions of Whites were observed in pediatric and elderly populations. Asians were predominantly males (98.1% vs. 85.7% in Whites, P<0.001) and frequently presented with aborted cardiac arrest (ACA) (71.1% vs. 56%, P<0.001). Asians tended to display more spontaneous type 1 BrS-ECG (71.5% vs. 64.3%, P=0.068). Family history of sudden cardiac death (FHSCD) was noted more in Whites (29.1% vs. 11.5%, P<0.001), with higher rate of SCN5A mutation carriers (40.1% vs. 13.2% in Asians, P<0.001), as well as more fever-related AEs (8.5% vs. 2.9%, 0.011). No difference was observed between the two groups regarding prior history of syncope and ventricular arrhythmia inducibility.

CONCLUSIONS: There are important differences between Asian and White BrS-patients. Asian patients present almost exclusively as male adults, more often with ACA and spontaneous type 1 BrS-ECG. However, they have less FHSCD and markedly lower SCN5A mutation rates. The striking difference in SCN5A mutation rates should be tested in future studies.

Original languageEnglish
Pages (from-to)1468-1474
Number of pages7
JournalHeart Rhythm
Volume16
Issue number10
Early online date5 Jul 2019
DOIs
Publication statusPublished - 1 Oct 2019

Bibliographical note

Copyright © 2019. Published by Elsevier Inc.

Keywords

  • Asian
  • Brugada Syndrome
  • SCN5A mutation
  • White
  • arrhythmic event

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