Gender differences in patients with Brugada syndrome and arrhythmic events: Data from a survey on arrhythmic events in 678 patients

BACKGROUND There is limited information on gender differences in patients with Brugada syndrome (BrS) who experienced arrhythmic events (AEs). OBJECTIVE The purpose of this study was to compare clinical, electrocardiographic (ECG), electrophysiological, and genetic characteristics between males and...

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Authors: Milman A; Gourraud JB; Andorin A; Postema PG; Sacher F; Mabo P; Conte G; Giustetto C; Sarquella-Brugada G; Hochstadt A; Kim SH; Juang JJ; Maeda S; Takahashi Y; Kamakura T; Aiba T; Leshem E; Michowitz Y; Rahkovich M; Mizusawa Y; Arbelo E; Huang Z; Denjoy I; Wijeyeratne YD; Napolitano C; Brugada R; Casado-Arroyo R; Champagne J; Calo L; Tfelt-Hansen J; Priori SG; Takagi M; Veltmann C; Delise P; Corrado D; Behr ER; Gaita F; Yan GX; Brugada J; Leenhardt A; Wilde AAM; Brugada P; Kusano KF; Hirao K; Nam GB; Probst V; Belhassen B
Format: Article
Status:Published version
Publication date:2018
Country:España
Institution:Fundació Sant Joan de Déu
Repository:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
OAI Identifier:oai:fsjd.fundanetsuite.com:p14546
Online Access:https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=14546
Access Level:Open access
Keyword:Brugada ECG
Ethnicity
Implantable cardioverter-de-fibrillator Ethnicity
SCN5A mutation
Sudden cardiac death
Summary:BACKGROUND There is limited information on gender differences in patients with Brugada syndrome (BrS) who experienced arrhythmic events (AEs). OBJECTIVE The purpose of this study was to compare clinical, electrocardiographic (ECG), electrophysiological, and genetic characteristics between males and females in patients with BrS with their first AE. METHODS The multicenter Survey on Arrhythmic Events in BRUgada Syndrome collected data on the first AE in 678 patients with BrS including 619 males (91.3%) and 59 females (8.7%) aged 0.27-84 years (mean age 42.5 +/- 14.1 years) at the time of AE occurrence. RESULTS After excluding pediatric patients, it was found that females were older than males (49.5 +/- 14.4 years vs 43 +/- 12.7 years, respectively; P = .001). Higher proportions of females were observed in the pediatric and elderly populations. In Asians, the male to female ratio for AEs was approximate to 9-fold higher than that in White. Spontaneous type 1 BrS ECG was associated with an earlier onset of AEs in pediatric females. A similar prevalence (approximate to 65%) of spontaneous type 1 BrS ECG was present in males and females above the age of 60 years. Females less frequently showed spontaneous type 1 BrS ECG (41% vs 69%; P < .001) or arrhythmia inducibility at electrophysiology study (36% vs 66%; P < .001). An SCN5A mutation was more frequently found in females (48% vs 28% in males; P = .007). CONCLUSION This study confirms that female patients with BrS are much rarer, display less type 1 Brugada ECG, and exhibit lower inducibility rates than domales. It shows for the first time that female patients with BrS with AE have higher SCN5A mutation rates as well as the relationship between gender vs age at the onset of AEs and ethnicity. (C) 2018 Heart Rhythm Society. All rights reserved.

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