• Int. J. Cardiol. · Aug 2017

    Etiological diagnosis, prognostic significance and role of electrophysiological study in patients with Brugada ECG and syncope.

    • Carla Giustetto, Natascia Cerrato, Enrico Ruffino, Elena Gribaudo, Chiara Scrocco, Lorella Barbonaglia, Francesca Bianchi, Miriam Bortnik, Guido Rossetti, Paula Carvalho, Riccardo Riccardi, Davide Castagno, Matteo Anselmino, Laura Bergamasco, and Fiorenzo Gaita.
    • Division of Cardiology, University of Torino, Department of Medical Sciences, "Città della Salute e della Scienza" Hospital, C.so A.M. Dogliotti 14, 10126 Torino, Italy. Electronic address: carla.giustetto@unito.it.
    • Int. J. Cardiol. 2017 Aug 15; 241: 188-193.

    BackgroundSyncope is considered a risk factor for life-threatening arrhythmias in Brugada patients. Distinguishing a benign syncope from one due to ventricular arrhythmias is often difficult, unless an ECG is recorded during the episode. Aim of the study was to analyze the characteristics of syncopal episodes in a large population of Brugada patients and evaluate the role of electrophysiological study (EPS) and the prognosis in the different subgroups.Methods And ResultsOne hundred ninety-five Brugada patients with history of syncope were considered. Syncope were classified as neurally mediated (group 1, 61%) or unexplained (group 2, 39%) on the basis of personal and family history, clinical features, triggers, situations, associated signs, concomitant therapy. Most patients underwent EPS; they received ICD or implantable loop-recorder on the basis of the result of investigations and physician's judgment. At 62±45months of mean follow-up, group 1 showed a significantly lower incidence of arrhythmic events (2%) as compared to group 2 (9%, p<0.001). Group 2 patients with positive EPS showed the highest risk of arrhythmic events (27%). No ventricular events occurred in subjects with negative EPS.ConclusionEtiological definition of syncope in Brugada patients is important, as it allows identifying two groups with different outcome. Patients with unexplained syncope and ventricular fibrillation induced at EPS have the highest risk of arrhythmic events. Patients presenting with neurally mediated syncope showed a prognosis similar to that of the asymptomatic and the role of EPS in this group is unproven.Copyright © 2017 Elsevier B.V. All rights reserved.

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