Ethnic differences in patients with Brugada syndrome and arrhythmic events: New insights from Survey on Arrhythmic Events in Brugada Syndrome

Anat Milman; Antoine Andorin; Pieter G. Postema; Jean Baptiste Gourraud; Frederic Sacher; Philippe Mabo; Sung Hwan Kim; Shingo Maeda; Yoshihide Takahashi; Tsukasa Kamakura; Takeshi Aiba; Giulio Conte; Jimmy J.M. Juang; Eran Leshem; Yoav Michowitz; Rami Fogelman; Aviram Hochstadt; Yuka Mizusawa; Carla Giustetto; Elena Arbelo; Zhengrong Huang; Domenico Corrado; Pietro Delise; Giuseppe Allocca; Masahiko Takagi; Yanushi D. Wijeyeratne; Andrea Mazzanti; Ramon Brugada; Ruben Casado-Arroyo; Jean Champagne; Leonardo Calo; Georgia Sarquella-Brugada; Camilla H. Jespersen; Jacob Tfelt-Hansen; Christian Veltmann; Silvia G. Priori; Elijah R. Behr; Gan Xin Yan; Josep Brugada; Fiorenzo Gaita; Arthur A.M. Wilde; Pedro Brugada; Kengo F. Kusano; Kenzo Hirao; Gi Byoung Nam; Vincent Probst; Bernard Belhassen

doi:10.1016/j.hrthm.2019.07.003

Ethnic differences in patients with Brugada syndrome and arrhythmic events: New insights from Survey on Arrhythmic Events in Brugada Syndrome

Anat Milman, Antoine Andorin, Pieter G. Postema, Jean Baptiste Gourraud, Frederic Sacher, Philippe Mabo, Sung Hwan Kim, Shingo Maeda, Yoshihide Takahashi, Tsukasa Kamakura, Takeshi Aiba, Giulio Conte, Jimmy J.M. Juang, Eran Leshem, Yoav Michowitz, Rami Fogelman, Aviram Hochstadt, Yuka Mizusawa, Carla Giustetto, Elena ArbeloZhengrong Huang, Domenico Corrado, Pietro Delise, Giuseppe Allocca, Masahiko Takagi, Yanushi D. Wijeyeratne, Andrea Mazzanti, Ramon Brugada, Ruben Casado-Arroyo, Jean Champagne, Leonardo Calo, Georgia Sarquella-Brugada, Camilla H. Jespersen, Jacob Tfelt-Hansen, Christian Veltmann, Silvia G. Priori, Elijah R. Behr, Gan Xin Yan, Josep Brugada, Fiorenzo Gaita, Arthur A.M. Wilde, Pedro Brugada, Kengo F. Kusano, Kenzo Hirao, Gi Byoung Nam, Vincent Probst, Bernard Belhassen^*

^*Corresponding author for this work

Section of Forensic Pathology

8 Citations (Scopus)

Abstract

Background: There is limited information on ethnic differences between patients with Brugada syndrome (BrS) and arrhythmic events (AEs). Objective: The purpose of this study was to compare clinical, electrocardiographic (ECG), electrophysiological, and genetic characteristics between white and Asian patients with BrS and AEs. Methods: The Survey on Arrhythmic Events in Brugada Syndrome is a multicenter survey from Western and Asian countries, gathering 678 patients with BrS and first documented AE. After excluding patients with other (n = 14 [2.1%]) or unknown (n = 30 [4.4%]) ethnicity, 364 (53.7%) whites and 270 (39.8%) Asians comprised the study group. Results: There was no difference in AE age onset (41.3 ± 16.1 years in whites vs 43.3 ± 12.3 years in Asians; P = .285). Higher proportions of whites were observed in pediatric and elderly populations. Asians were predominantly men (98.1% vs 85.7% in whites; P < .001) and frequently presented with aborted cardiac arrest (71.1% vs 56%; P < .001). Asians tended to display more spontaneous type 1 BrS-ECG pattern (71.5% vs 64.3%; P = .068). A family history of sudden cardiac death was noted more in whites (29.1% vs 11.5%; P < .001), with a higher rate of SCN5A mutation carriers (40.1% vs 13.2% in Asians; P < .001), as well as more fever-related AEs (8.5% vs 2.9%; P = .011). No difference was observed between the 2 groups regarding history of syncope and ventricular arrhythmia inducibility. Conclusion: There are important differences between Asian and white patients with BrS. Asian patients present almost exclusively as male adults, more often with aborted cardiac arrest and spontaneous type 1 BrS-ECG. However, they have less family history of sudden cardiac death and markedly lower SCN5A mutation rates. The striking difference in SCN5A mutation rates should be tested in future studies.

Original language	English
Journal	Heart Rhythm
Volume	16
Issue number	10
Pages (from-to)	1468-1474
ISSN	1547-5271
DOIs	https://doi.org/10.1016/j.hrthm.2019.07.003
Publication status	Published - 1 Oct 2019

Keywords

Arrhythmic event
Asian
Brugada syndrome
SCN5A mutation
White

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10.1016/j.hrthm.2019.07.003

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Milman, A., Andorin, A., Postema, P. G., Gourraud, J. B., Sacher, F., Mabo, P., Kim, S. H., Maeda, S., Takahashi, Y., Kamakura, T., Aiba, T., Conte, G., Juang, J. J. M., Leshem, E., Michowitz, Y., Fogelman, R., Hochstadt, A., Mizusawa, Y., Giustetto, C., ... Belhassen, B. (2019). Ethnic differences in patients with Brugada syndrome and arrhythmic events: New insights from Survey on Arrhythmic Events in Brugada Syndrome. Heart Rhythm, 16(10), 1468-1474. https://doi.org/10.1016/j.hrthm.2019.07.003

Milman, A, Andorin, A, Postema, PG, Gourraud, JB, Sacher, F, Mabo, P, Kim, SH, Maeda, S, Takahashi, Y, Kamakura, T, Aiba, T, Conte, G, Juang, JJM, Leshem, E, Michowitz, Y, Fogelman, R, Hochstadt, A, Mizusawa, Y, Giustetto, C, Arbelo, E, Huang, Z, Corrado, D, Delise, P, Allocca, G, Takagi, M, Wijeyeratne, YD, Mazzanti, A, Brugada, R, Casado-Arroyo, R, Champagne, J, Calo, L, Sarquella-Brugada, G, Jespersen, CH, Tfelt-Hansen, J, Veltmann, C, Priori, SG, Behr, ER, Yan, GX, Brugada, J, Gaita, F, Wilde, AAM, Brugada, P, Kusano, KF, Hirao, K, Nam, GB, Probst, V & Belhassen, B 2019, 'Ethnic differences in patients with Brugada syndrome and arrhythmic events: New insights from Survey on Arrhythmic Events in Brugada Syndrome', Heart Rhythm, vol. 16, no. 10, pp. 1468-1474. https://doi.org/10.1016/j.hrthm.2019.07.003

@article{4fea64baa495471c86b5fc4929a9007f,

title = "Ethnic differences in patients with Brugada syndrome and arrhythmic events: New insights from Survey on Arrhythmic Events in Brugada Syndrome",

abstract = "Background: There is limited information on ethnic differences between patients with Brugada syndrome (BrS) and arrhythmic events (AEs). Objective: The purpose of this study was to compare clinical, electrocardiographic (ECG), electrophysiological, and genetic characteristics between white and Asian patients with BrS and AEs. Methods: The Survey on Arrhythmic Events in Brugada Syndrome is a multicenter survey from Western and Asian countries, gathering 678 patients with BrS and first documented AE. After excluding patients with other (n = 14 [2.1%]) or unknown (n = 30 [4.4%]) ethnicity, 364 (53.7%) whites and 270 (39.8%) Asians comprised the study group. Results: There was no difference in AE age onset (41.3 ± 16.1 years in whites vs 43.3 ± 12.3 years in Asians; P = .285). Higher proportions of whites were observed in pediatric and elderly populations. Asians were predominantly men (98.1% vs 85.7% in whites; P < .001) and frequently presented with aborted cardiac arrest (71.1% vs 56%; P < .001). Asians tended to display more spontaneous type 1 BrS-ECG pattern (71.5% vs 64.3%; P = .068). A family history of sudden cardiac death was noted more in whites (29.1% vs 11.5%; P < .001), with a higher rate of SCN5A mutation carriers (40.1% vs 13.2% in Asians; P < .001), as well as more fever-related AEs (8.5% vs 2.9%; P = .011). No difference was observed between the 2 groups regarding history of syncope and ventricular arrhythmia inducibility. Conclusion: There are important differences between Asian and white patients with BrS. Asian patients present almost exclusively as male adults, more often with aborted cardiac arrest and spontaneous type 1 BrS-ECG. However, they have less family history of sudden cardiac death and markedly lower SCN5A mutation rates. The striking difference in SCN5A mutation rates should be tested in future studies.",

keywords = "Arrhythmic event, Asian, Brugada syndrome, SCN5A mutation, White",

author = "Anat Milman and Antoine Andorin and Postema, {Pieter G.} and Gourraud, {Jean Baptiste} and Frederic Sacher and Philippe Mabo and Kim, {Sung Hwan} and Shingo Maeda and Yoshihide Takahashi and Tsukasa Kamakura and Takeshi Aiba and Giulio Conte and Juang, {Jimmy J.M.} and Eran Leshem and Yoav Michowitz and Rami Fogelman and Aviram Hochstadt and Yuka Mizusawa and Carla Giustetto and Elena Arbelo and Zhengrong Huang and Domenico Corrado and Pietro Delise and Giuseppe Allocca and Masahiko Takagi and Wijeyeratne, {Yanushi D.} and Andrea Mazzanti and Ramon Brugada and Ruben Casado-Arroyo and Jean Champagne and Leonardo Calo and Georgia Sarquella-Brugada and Jespersen, {Camilla H.} and Jacob Tfelt-Hansen and Christian Veltmann and Priori, {Silvia G.} and Behr, {Elijah R.} and Yan, {Gan Xin} and Josep Brugada and Fiorenzo Gaita and Wilde, {Arthur A.M.} and Pedro Brugada and Kusano, {Kengo F.} and Kenzo Hirao and Nam, {Gi Byoung} and Vincent Probst and Bernard Belhassen",

year = "2019",

month = oct,

day = "1",

doi = "10.1016/j.hrthm.2019.07.003",

language = "English",

volume = "16",

pages = "1468--1474",

journal = "Heart Rhythm",

issn = "1547-5271",

publisher = "Elsevier",

number = "10",

}

TY - JOUR

T1 - Ethnic differences in patients with Brugada syndrome and arrhythmic events

T2 - New insights from Survey on Arrhythmic Events in Brugada Syndrome

AU - Milman, Anat

AU - Andorin, Antoine

AU - Postema, Pieter G.

AU - Gourraud, Jean Baptiste

AU - Sacher, Frederic

AU - Mabo, Philippe

AU - Kim, Sung Hwan

AU - Maeda, Shingo

AU - Takahashi, Yoshihide

AU - Kamakura, Tsukasa

AU - Aiba, Takeshi

AU - Conte, Giulio

AU - Juang, Jimmy J.M.

AU - Leshem, Eran

AU - Michowitz, Yoav

AU - Fogelman, Rami

AU - Hochstadt, Aviram

AU - Mizusawa, Yuka

AU - Giustetto, Carla

AU - Arbelo, Elena

AU - Huang, Zhengrong

AU - Corrado, Domenico

AU - Delise, Pietro

AU - Allocca, Giuseppe

AU - Takagi, Masahiko

AU - Wijeyeratne, Yanushi D.

AU - Mazzanti, Andrea

AU - Brugada, Ramon

AU - Casado-Arroyo, Ruben

AU - Champagne, Jean

AU - Calo, Leonardo

AU - Sarquella-Brugada, Georgia

AU - Jespersen, Camilla H.

AU - Tfelt-Hansen, Jacob

AU - Veltmann, Christian

AU - Priori, Silvia G.

AU - Behr, Elijah R.

AU - Yan, Gan Xin

AU - Brugada, Josep

AU - Gaita, Fiorenzo

AU - Wilde, Arthur A.M.

AU - Brugada, Pedro

AU - Kusano, Kengo F.

AU - Hirao, Kenzo

AU - Nam, Gi Byoung

AU - Probst, Vincent

AU - Belhassen, Bernard

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Background: There is limited information on ethnic differences between patients with Brugada syndrome (BrS) and arrhythmic events (AEs). Objective: The purpose of this study was to compare clinical, electrocardiographic (ECG), electrophysiological, and genetic characteristics between white and Asian patients with BrS and AEs. Methods: The Survey on Arrhythmic Events in Brugada Syndrome is a multicenter survey from Western and Asian countries, gathering 678 patients with BrS and first documented AE. After excluding patients with other (n = 14 [2.1%]) or unknown (n = 30 [4.4%]) ethnicity, 364 (53.7%) whites and 270 (39.8%) Asians comprised the study group. Results: There was no difference in AE age onset (41.3 ± 16.1 years in whites vs 43.3 ± 12.3 years in Asians; P = .285). Higher proportions of whites were observed in pediatric and elderly populations. Asians were predominantly men (98.1% vs 85.7% in whites; P < .001) and frequently presented with aborted cardiac arrest (71.1% vs 56%; P < .001). Asians tended to display more spontaneous type 1 BrS-ECG pattern (71.5% vs 64.3%; P = .068). A family history of sudden cardiac death was noted more in whites (29.1% vs 11.5%; P < .001), with a higher rate of SCN5A mutation carriers (40.1% vs 13.2% in Asians; P < .001), as well as more fever-related AEs (8.5% vs 2.9%; P = .011). No difference was observed between the 2 groups regarding history of syncope and ventricular arrhythmia inducibility. Conclusion: There are important differences between Asian and white patients with BrS. Asian patients present almost exclusively as male adults, more often with aborted cardiac arrest and spontaneous type 1 BrS-ECG. However, they have less family history of sudden cardiac death and markedly lower SCN5A mutation rates. The striking difference in SCN5A mutation rates should be tested in future studies.

AB - Background: There is limited information on ethnic differences between patients with Brugada syndrome (BrS) and arrhythmic events (AEs). Objective: The purpose of this study was to compare clinical, electrocardiographic (ECG), electrophysiological, and genetic characteristics between white and Asian patients with BrS and AEs. Methods: The Survey on Arrhythmic Events in Brugada Syndrome is a multicenter survey from Western and Asian countries, gathering 678 patients with BrS and first documented AE. After excluding patients with other (n = 14 [2.1%]) or unknown (n = 30 [4.4%]) ethnicity, 364 (53.7%) whites and 270 (39.8%) Asians comprised the study group. Results: There was no difference in AE age onset (41.3 ± 16.1 years in whites vs 43.3 ± 12.3 years in Asians; P = .285). Higher proportions of whites were observed in pediatric and elderly populations. Asians were predominantly men (98.1% vs 85.7% in whites; P < .001) and frequently presented with aborted cardiac arrest (71.1% vs 56%; P < .001). Asians tended to display more spontaneous type 1 BrS-ECG pattern (71.5% vs 64.3%; P = .068). A family history of sudden cardiac death was noted more in whites (29.1% vs 11.5%; P < .001), with a higher rate of SCN5A mutation carriers (40.1% vs 13.2% in Asians; P < .001), as well as more fever-related AEs (8.5% vs 2.9%; P = .011). No difference was observed between the 2 groups regarding history of syncope and ventricular arrhythmia inducibility. Conclusion: There are important differences between Asian and white patients with BrS. Asian patients present almost exclusively as male adults, more often with aborted cardiac arrest and spontaneous type 1 BrS-ECG. However, they have less family history of sudden cardiac death and markedly lower SCN5A mutation rates. The striking difference in SCN5A mutation rates should be tested in future studies.

KW - Arrhythmic event

KW - Asian

KW - Brugada syndrome

KW - SCN5A mutation

KW - White

UR - http://www.scopus.com/inward/record.url?scp=85072284665&partnerID=8YFLogxK

U2 - 10.1016/j.hrthm.2019.07.003

DO - 10.1016/j.hrthm.2019.07.003

M3 - Journal article

C2 - 31284050

AN - SCOPUS:85072284665

SN - 1547-5271

VL - 16

SP - 1468

EP - 1474

JO - Heart Rhythm

JF - Heart Rhythm

IS - 10

ER -

Ethnic differences in patients with Brugada syndrome and arrhythmic events: New insights from Survey on Arrhythmic Events in Brugada Syndrome

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