TY - JOUR
T1 - Are women with severely symptomatic Brugada syndrome different from men?
AU - Sacher, Frédéric
AU - Meregalli, Paola
AU - Veltmann, Christian
AU - Field, Michael E.
AU - Solnon, Aude
AU - Bru, Paul
AU - Abbey, Sélim
AU - Jaïs, Pierre
AU - Tan, Hanno L.
AU - Wolpert, Christian
AU - Lande, Gilles
AU - Bertault, Valérie
AU - Derval, Nicolas
AU - Babuty, Dominique
AU - Lacroix, Dominique
AU - Boveda, Serge
AU - Maury, Philippe
AU - Hocini, Mélèze
AU - Clémenty, Jacques
AU - Mabo, Philippe
AU - Lemarec, Hervé
AU - Mansourati, Jacques
AU - Borggrefe, Martin
AU - Wilde, Arthur
AU - Haïssaguerre, Michel
AU - Probst, Vincent
PY - 2008/11
Y1 - 2008/11
N2 - Women with Brugada Syndrome. Introduction: Spontaneous type-1 ECG has been recognized as a risk factor for sudden cardiac death (SCD) in Brugada syndrome (BrS), but studied populations predominantly consisted of men. We sought to investigate whether a spontaneous type-1 ECG pattern was also associated in women with severely symptomatic BrS. Other known risk factors were also examined for gender specificity. Methods: Patients with severely symptomatic BrS, defined as resuscitated SCD and/or appropriate implantable cardioverter- defibrillator (ICD) shock, were included from 11 European centers. Clinical data, investigation of family history, 12-lead ECG, and results of electrophysiological study (EPS) were collected. The average follow-up was 4 ± 3 years. Results: Fifty-eight patients fulfilled the inclusion criteria (mean age 47 ± 11 years, 8 women). Thirty-six men (72%) but only two women (25%) had a spontaneous type-1 ECG at baseline (P = 0.02). Maximal ST elevation before or after drug challenge was 3.7 ± 1.3 mm in men versus 2.4 ± 0.7 mm in women (P = 0.007). The proportion of patients with a family history of SCD or an SCN5A mutation was not significantly different between both groups. Of those patients with high-risk BrS who underwent EPS, 76%(12/25) of men and 50%(2/4) of women had a positive study. Conclusion: In contrast to men, most women with BrS and resuscitated SCD or appropriate ICD shock do not have a spontaneous type-1 ECG pattern. In addition, the degree of ST elevation is less pronounced in women than men. While women represent a lower-risk group overall, risk factors established from a predominantly male population may not be helpful in identifying high-risk females.
AB - Women with Brugada Syndrome. Introduction: Spontaneous type-1 ECG has been recognized as a risk factor for sudden cardiac death (SCD) in Brugada syndrome (BrS), but studied populations predominantly consisted of men. We sought to investigate whether a spontaneous type-1 ECG pattern was also associated in women with severely symptomatic BrS. Other known risk factors were also examined for gender specificity. Methods: Patients with severely symptomatic BrS, defined as resuscitated SCD and/or appropriate implantable cardioverter- defibrillator (ICD) shock, were included from 11 European centers. Clinical data, investigation of family history, 12-lead ECG, and results of electrophysiological study (EPS) were collected. The average follow-up was 4 ± 3 years. Results: Fifty-eight patients fulfilled the inclusion criteria (mean age 47 ± 11 years, 8 women). Thirty-six men (72%) but only two women (25%) had a spontaneous type-1 ECG at baseline (P = 0.02). Maximal ST elevation before or after drug challenge was 3.7 ± 1.3 mm in men versus 2.4 ± 0.7 mm in women (P = 0.007). The proportion of patients with a family history of SCD or an SCN5A mutation was not significantly different between both groups. Of those patients with high-risk BrS who underwent EPS, 76%(12/25) of men and 50%(2/4) of women had a positive study. Conclusion: In contrast to men, most women with BrS and resuscitated SCD or appropriate ICD shock do not have a spontaneous type-1 ECG pattern. In addition, the degree of ST elevation is less pronounced in women than men. While women represent a lower-risk group overall, risk factors established from a predominantly male population may not be helpful in identifying high-risk females.
KW - Brugada syndrome
KW - Gender
KW - Implantable defibrillator
KW - Sudden cardiac death
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U2 - 10.1111/j.1540-8167.2008.01223.x
DO - 10.1111/j.1540-8167.2008.01223.x
M3 - Article
C2 - 18554195
AN - SCOPUS:55449134632
VL - 19
SP - 1181
EP - 1185
JO - Journal of Cardiovascular Electrophysiology
JF - Journal of Cardiovascular Electrophysiology
SN - 1045-3873
IS - 11
ER -