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 Arbelo; Zhengrong 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

doi:10.1016/j.hrthm.2019.07.003

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 journal › Article › peer-review

23 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 language	English
Pages (from-to)	1468-1474
Number of pages	7
Journal	Heart Rhythm
Volume	16
Issue number	10
Early online date	5 Jul 2019
DOIs	https://doi.org/10.1016/j.hrthm.2019.07.003
Publication status	Published - 1 Oct 2019

Bibliographical note

Keywords

Asian
Brugada Syndrome
SCN5A mutation
White
arrhythmic event

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10.1016/j.hrthm.2019.07.003

Cite this

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., Juang, J. J., Leshem, E., Michowitz, Y., Fogelman, R., Hochstadt, A., Mizusawa, Y., Giustetto, C., ... Belhassen, B. (2019). Ethnic Differences in Patients with Brugada Syndrome and Arrhythmic Events: New insights from Survey on Arrhythmic Events in Brugada Syndrome. Heart Rhythm, 16(10), 1468-1474. https://doi.org/10.1016/j.hrthm.2019.07.003

@article{889db1872d8c46c697676cb331922334,

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

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.",

keywords = "Asian, Brugada Syndrome, SCN5A mutation, White, arrhythmic event",

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

note = "Copyright {\textcopyright} 2019. Published by Elsevier Inc.",

year = "2019",

month = oct,

day = "1",

doi = "10.1016/j.hrthm.2019.07.003",

language = "English",

volume = "16",

pages = "1468--1474",

journal = "Heart Rhythm",

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Milman, A, Andorin, A, Postema, PG, Gourraud, J-B, Sacher, F, Mabo, P, Kim, S-H, Maeda, S, Takahashi, Y, Kamakura, T, Aiba, T, Conte, G, Juang, JJ, 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, YD, Mazzanti, A, Brugada, R, Casado-Arroyo, R, Champagne, J, Calo, L, Sarquella-Brugada, G, Jespersen, CH, Tfelt-Hansen, J, Veltmann, C, Priori, SG, Behr, ER, Yan, G-X, Brugada, J, Gaita, F, Wilde, AAM, Brugada, P, Kusano, KF, Hirao, K, Nam, G-B, Probst, V & Belhassen, B 2019, 'Ethnic Differences in Patients with Brugada Syndrome and Arrhythmic Events: New insights from Survey on Arrhythmic Events in Brugada Syndrome', Heart Rhythm, vol. 16, no. 10, pp. 1468-1474. https://doi.org/10.1016/j.hrthm.2019.07.003

TY - JOUR

T1 - Ethnic Differences in Patients with Brugada Syndrome and Arrhythmic Events

T2 - New insights from Survey on Arrhythmic Events in Brugada Syndrome

AU - Milman, Anat

AU - Andorin, Antoine

AU - Postema, Pieter G

AU - Gourraud, Jean-Baptiste

AU - Sacher, Frederic

AU - Mabo, Philippe

AU - Kim, Sung-Hwan

AU - Maeda, Shingo

AU - Takahashi, Yoshihide

AU - Kamakura, Tsukasa

AU - Aiba, Takeshi

AU - Conte, Giulio

AU - Juang, Jimmy Jm

AU - Leshem, Eran

AU - Michowitz, Yoav

AU - Fogelman, Rami

AU - Hochstadt, Aviram

AU - Mizusawa, Yuka

AU - Giustetto, Carla

AU - Arbelo, Elena

AU - Huang, Zhengrong

AU - Corrado, Domenico

AU - Delise, Pietro

AU - Allocca, Giuseppe

AU - Takagi, Masahiko

AU - Wijeyeratne, Yanushi D

AU - Mazzanti, Andrea

AU - Brugada, Ramon

AU - Casado-Arroyo, Ruben

AU - Champagne, Jean

AU - Calo, Leonardo

AU - Sarquella-Brugada, Georgia

AU - Jespersen, Camilla H

AU - Tfelt-Hansen, Jacob

AU - Veltmann, Christian

AU - Priori, Silvia G

AU - Behr, Elijah R

AU - Yan, Gan-Xin

AU - Brugada, Josep

AU - Gaita, Fiorenzo

AU - Wilde, Arthur A M

AU - Brugada, Pedro

AU - Kusano, Kengo F

AU - Hirao, Kenzo

AU - Nam, Gi-Byoung

AU - Probst, Vincent

AU - Belhassen, Bernard

PY - 2019/10/1

Y1 - 2019/10/1

N2 - 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.

AB - 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.

KW - Asian

KW - Brugada Syndrome

KW - SCN5A mutation

KW - White

KW - arrhythmic event

UR - http://www.scopus.com/inward/record.url?scp=85072284665&partnerID=8YFLogxK

U2 - 10.1016/j.hrthm.2019.07.003

DO - 10.1016/j.hrthm.2019.07.003

M3 - Article

C2 - 31284050

SN - 1547-5271

VL - 16

SP - 1468

EP - 1474

JO - Heart Rhythm

JF - Heart Rhythm

IS - 10

ER -

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

Abstract

Bibliographical note

Keywords

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