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.
Bibliographical noteCopyright © 2019. Published by Elsevier Inc.
- Brugada Syndrome
- SCN5A mutation
- arrhythmic event