Clinical Characteristics and Long-Term Prognosis of Senior Patients With Brugada Syndrome

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• 作者：Takeshi Kitamura ; MD^a ; ^{take1124@hotmail.co.jp} ; Seiji Fukamizu ; MD^a ; Iwanari Kawamura ; MD^a ; Rintaro Hojo ; MD^a ; Yuya Aoyama ; MD ; PhD^a ; Mitsuhiro Nishizaki ; MD ; PhD^b ; Masayasu Hiraoka ; MD ; PhD^c ; Harumizu Sakurada ; MD ; PhD^d
• 关键词：Brugada syndrome ; implantable cardioverter-defibrillator ; ventricular fibrillation
• 刊名：JACC: Clinical Electrophysiology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：3
• 期：1
• 页码：57-67
• 全文大小：1003 K
• 卷排序：3

文摘

This study investigated clinical characteristics and prognosis of Brugada syndrome (BrS) in patients older than 60 years of age during a long-term follow-up period.BackgroundClinical characteristics and prognosis of senior patients with BrS have not been clearly elucidated.MethodsA total of 181 patients with BrS were divided into 2 groups by age at the time of diagnosis: the younger group was <60 years of age (n = 123), and the senior group was ≥60 years of age (n = 58).ResultsMean ages were 42.7 ± 11 years and 68.6 ± 7.1 years, respectively. Prevalence of spontaneous type 1 electrocardiogram (ECG) was lower in the senior group (22 of 58; 37.9%) than in the younger group (64 of 123; 51.9%) (p = 0.027). Among various ECG parameters, the senior group had a lower incidence of prolonged r-J intervals in V2 ≥90 ms than the younger group (34 of 58; 58.6% vs. 90 of 123; 73.1%, p = 0.049) and day-to-day variation of Brugada ECG patterns (3 of 58; 5.2% vs. 23 of 123; 18.7%, p = 0.032). During a mean follow-up period of 7.6 ± 5.8 years, no senior patients experienced documented fatal ventricular arrhythmias, but 11 younger patients did. Kaplan-Meier analysis revealed a better prognosis in the senior group than in the younger group (log-rank, p = 0.011).ConclusionsSenior BrS patients, ≥60 years of age, had a better prognosis than those <60 years of age. Implantable cardioverter-defibrillator insertion for senior patients with BrS needs careful consideration.