Long-term prognosis of women with Brugada syndrome and electrophysiological study
Por:
Rodriuez-Manero, M, Jorda, P, Hernandez, J, Munoz, C, Grima, EZ, Garcia-Fernandez, A, Canadas-Godoy, MV, Jimenez-Ramos, V, Oloriz, T, Basterra, N, Calvo, D, Perez-Alvarez, L, Arias, MA, Exposito, V, Aleman, A, Diaz-Infante, E, Guerra-Ramos, JM, Fernandez-Armenta, J, Arce-Leon, A, Sanchez-Gomez, JM, Sousa, P, Garcia-Bolao, I, Baluja, A, Campuzano, O, Sarquella-Brugada, G, Martinez-Sande, JL, Gonzalez-Juanatey, JR, Gimeno, JR, Brugada, J, Arbelo, E
Publicada:
1 may 2021
Ahead of Print:
1 abr 2021
Resumen:
BACKGROUND A male predominance in Brugada syndrome (BrS) has been widely reported, but scarce information on female patients with BrS is available.
OBJECTIVE The purpose of this study was to investigate clinical characteristics and long-term prognosis of women with BrS.
METHODS A multicenter retrospective study of patients diagnosed with BrS and previous electrophysiological study (EPS) was performed.
RESULTS Among 770 patients, 177 (23%) were female. At presentation, 150 (84.7%) were asymptomatic. Females presented less frequently with a type 1 electrocardiographic pattern (30.5% vs 55.0%; P <.001), had a higher rate of family history of sudden cardiac death (49.7% vs 29.8%; P <.001), and had less sustained ventricular arrhythmias (VAs) on EPS (8.5% vs 15.1%; P = .009). Genetic testing was performed in 79 females (45% of the sample) and was positive in 34 (19%). An implantable cardioverter-defibrillator was inserted in 48 females (27.1%). During mean (+/- SD) follow-up of 122.17 +/- 57.28 months, 5 females (2.8%) experienced a cardiovascular event compared to 42 males (7.1%; P = .04). On multivariable analysis, a positive genetic test (18.71; 95% confidence interval [CI] 1.82-192.53; P = .01) and atrial fibrillation (odds ratio 21.12; 95% CI 1.27-350.85; P = .03) were predictive of arrhythmic events, whereas VAs on EPS (neither with 1 or 2 extrastimuli nor 3 extrastimuli) were not.
CONCLUSION Women with BrS represent a minor fraction among patients with BrS, and although their rate of events is low, they do not constitute a risk-free group. Neither clinical risk factors nor EPS predicts future arrhythmic events. Only atrial fibrillation and positive genetic test were identified as risk factors for future arrhythmic events.
Filiaciones:
Rodriuez-Manero, M:
Hosp Univ Santiago Compostela, Dept Cardiol, La Coruna, Spain
Jorda, P:
Inst Thorax, Dept Cardiol, Barcelona, Spain
Hernandez, J:
Inst Thorax, Dept Cardiol, Barcelona, Spain
Munoz, C:
Hosp Univ Murcia, Dept Cardiol, Murcia, Spain
Grima, EZ:
Hosp Univ La Fe, Dept Cardiol, Valencia, Spain
Garcia-Fernandez, A:
Hosp Univ Gen Alicante, Dept Cardiol, Valencia, Spain
Canadas-Godoy, MV:
Hosp Univ Clin Madrid, Dept Cardiol, Madrid, Spain
Jimenez-Ramos, V:
Hosp Univ Santiago Compostela, Dept Cardiol, La Coruna, Spain
Oloriz, T:
Hosp Univ Clin Zaragoza, Dept Cardiol, Zaragoza, Spain
Basterra, N:
Hosp Univ Navarra, Dept Cardiol, Pamplona, Spain
Calvo, D:
Hosp Univ Cent Asturias, Dept Cardiol, Oviedo, Spain
Perez-Alvarez, L:
Complejo Hosp Canalejo, La Coruna, Spain
Arias, MA:
Hosp Univ Virgen La Salud, Dept Cardiol, Toledo, Spain
Exposito, V:
Hosp Univ Marques Valdecilla, Dept Cardiol, Santander, Spain
Aleman, A:
Hosp Univ Vigo, Dept Cardiol, Pontevedra, Galicia, Spain
Diaz-Infante, E:
Hosp Univ Virgen La Macarena, Dept Cardiol, Seville, Spain
Guerra-Ramos, JM:
Hosp Univ San Pau Barcelona, Dept Cardiol, Barcelona, Spain
Fernandez-Armenta, J:
Hosp Univ Puerta Mar, Dept Cardiol, Cadiz, Spain
Arce-Leon, A:
Hosp Univ Juan Ramon Jimenez, Dept Cardiol, Huelva, Spain
Sanchez-Gomez, JM:
Hosp Univ Clin Valencia, Dept Cardiol, Valencia, Spain
Sousa, P:
CHU Coimbra, Dept Cardiol, Electrophysiol Unit, Coimbra, Portugal
Garcia-Bolao, I:
Hosp Univ Santiago Compostela, Anestesiol Dept, La Coruna, Spain
Baluja, A:
Clin Univ Navarra, Pamplona, Spain
Campuzano, O:
Inst Thorax, Dept Cardiol, Barcelona, Spain
Sarquella-Brugada, G:
Inst Thorax, Dept Cardiol, Barcelona, Spain
Martinez-Sande, JL:
Hosp Univ Santiago Compostela, Dept Cardiol, La Coruna, Spain
Gonzalez-Juanatey, JR:
Hosp Univ Santiago Compostela, Dept Cardiol, La Coruna, Spain
Gimeno, JR:
Hosp Univ Murcia, Dept Cardiol, Murcia, Spain
Brugada, J:
Inst Thorax, Dept Cardiol, Barcelona, Spain
Arbelo, E:
Inst Thorax, Dept Cardiol, Barcelona, Spain
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