TY - JOUR
T1 - New-onset atrial fibrillation as first clinical manifestation of latent Brugada syndrome
T2 - Prevalence and clinical significance
AU - Pappone, Carlo
AU - Radinovic, Andrea
AU - Manguso, Francesco
AU - Vicedomini, Gabriele
AU - Sala, Simone
AU - Sacco, Francesco Maria
AU - Ciconte, Giuseppe
AU - Saviano, Massimo
AU - Ferrari, Maurizio
AU - Sommariva, Elena
AU - Sacchi, Stefania
AU - Ciaccio, Cristiano
AU - Kallergis, Eleftherios M.
AU - Santinelli, Vincenzo
PY - 2009/12
Y1 - 2009/12
N2 - Aims: To evaluate the prevalence, clinical significance, and prognosis of latent Brugada syndrome (BrS) in patients with new-onset atrial fibrillation (AF) unmasked by class 1C antiarrhythmic drugs.Methods and resultsBetween January 2000 and June 2008, all consecutive patients with new-onset AF, who after flecainide exhibited typical Brugada ECG pattern, underwent electrophysiologic, pharmacologic, and genetic testing. Among 346 patients [median age 53 years; interquartile range (IQR), 15], 11 (3.2; median age 51 years; IQR, 19) diagnosed as lone AF exhibited typical Brugada ECG pattern. Genetic testing was negative. Ventricular tachycardia/ventricular fibrillation (VT/VF) was induced by electrophysiologic testing (five patients) or during flecainide infusion (one patient). Six patients with type 1 ECG pattern and inducible VT/VF underwent ICD implantation. During a median follow-up of 31.5 months (range: 10-85) after ICD implantation, three patients developed BrS and one of them experienced VF. Patients without ICD (five patients) remained asymptomatic during a median follow-up of 74 months. Persistent type 1 pattern occurred only in the three patients who developed BrS.ConclusionThis study, for the first time, reveals the prevalence of latent BrS in patients with new-onset lone AF, which may precede VT/VF. Persistence of type 1 and ventricular tachyarrhythmias inducibility represents a marker of electrical instability leading to sudden death.
AB - Aims: To evaluate the prevalence, clinical significance, and prognosis of latent Brugada syndrome (BrS) in patients with new-onset atrial fibrillation (AF) unmasked by class 1C antiarrhythmic drugs.Methods and resultsBetween January 2000 and June 2008, all consecutive patients with new-onset AF, who after flecainide exhibited typical Brugada ECG pattern, underwent electrophysiologic, pharmacologic, and genetic testing. Among 346 patients [median age 53 years; interquartile range (IQR), 15], 11 (3.2; median age 51 years; IQR, 19) diagnosed as lone AF exhibited typical Brugada ECG pattern. Genetic testing was negative. Ventricular tachycardia/ventricular fibrillation (VT/VF) was induced by electrophysiologic testing (five patients) or during flecainide infusion (one patient). Six patients with type 1 ECG pattern and inducible VT/VF underwent ICD implantation. During a median follow-up of 31.5 months (range: 10-85) after ICD implantation, three patients developed BrS and one of them experienced VF. Patients without ICD (five patients) remained asymptomatic during a median follow-up of 74 months. Persistent type 1 pattern occurred only in the three patients who developed BrS.ConclusionThis study, for the first time, reveals the prevalence of latent BrS in patients with new-onset lone AF, which may precede VT/VF. Persistence of type 1 and ventricular tachyarrhythmias inducibility represents a marker of electrical instability leading to sudden death.
KW - Atrial fibrillation
KW - Brugada syndrome
KW - Sudden cardiac death
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U2 - 10.1093/eurheartj/ehp326
DO - 10.1093/eurheartj/ehp326
M3 - Article
C2 - 19696190
AN - SCOPUS:72649088295
VL - 30
SP - 2985
EP - 2992
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 24
ER -