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

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

doi:10.1016/j.hrthm.2018.06.019

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

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

^*Corresponding author for this work

22 Citations (Scopus)

Abstract

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 ≈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 (≈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 do males. 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.

Original language	English
Journal	Heart Rhythm
Volume	15
Issue number	10
Pages (from-to)	1457-1465
Number of pages	9
ISSN	1547-5271
DOIs	https://doi.org/10.1016/j.hrthm.2018.06.019
Publication status	Published - 1 Oct 2018

Keywords

Brugada ECG
Ethnicity
Implantable cardioverter-defibrillatorEthnicity
SCN5A mutation
Sudden cardiac death

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10.1016/j.hrthm.2018.06.019

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Milman, A., Gourraud, J. B., Andorin, A., Postema, P. G., Sacher, F., Mabo, P., Conte, G., Giustetto, C., Sarquella-Brugada, G., Hochstadt, A., Kim, S. H., Juang, J. J. M., Maeda, S., Takahashi, Y., Kamakura, T., Aiba, T., Leshem, E., Michowitz, Y., Rahkovich, M., ... Belhassen, B. (2018). Gender differences in patients with Brugada syndrome and arrhythmic events: Data from a survey on arrhythmic events in 678 patients. Heart Rhythm, 15(10), 1457-1465. https://doi.org/10.1016/j.hrthm.2018.06.019

Milman, A, Gourraud, JB, Andorin, A, Postema, PG, Sacher, F, Mabo, P, Conte, G, Giustetto, C, Sarquella-Brugada, G, Hochstadt, A, Kim, SH, Juang, JJM, 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 2018, 'Gender differences in patients with Brugada syndrome and arrhythmic events: Data from a survey on arrhythmic events in 678 patients', Heart Rhythm, vol. 15, no. 10, pp. 1457-1465. https://doi.org/10.1016/j.hrthm.2018.06.019

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

abstract = "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 ≈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 (≈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 do males. 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.",

keywords = "Brugada ECG, Ethnicity, Implantable cardioverter-defibrillatorEthnicity, SCN5A mutation, Sudden cardiac death",

author = "Anat Milman and Gourraud, {Jean Baptiste} and Antoine Andorin and Postema, {Pieter G.} and Frederic Sacher and Philippe Mabo and Giulio Conte and Carla Giustetto and Georgia Sarquella-Brugada and Aviram Hochstadt and Kim, {Sung Hwan} and Juang, {Jimmy J.M.} and Shingo Maeda and Yoshihide Takahashi and Tsukasa Kamakura and Takeshi Aiba and Eran Leshem and Yoav Michowitz and Michael Rahkovich and Yuka Mizusawa and Elena Arbelo and Zhengrong Huang and Isabelle Denjoy and Wijeyeratne, {Yanushi D.} and Carlo Napolitano and Ramon Brugada and Ruben Casado-Arroyo and Jean Champagne and Leonardo Calo and Jacob Tfelt-Hansen and Priori, {Silvia G.} and Masahiko Takagi and Christian Veltmann and Pietro Delise and Domenico Corrado and Behr, {Elijah R.} and Fiorenzo Gaita and Yan, {Gan Xin} and Josep Brugada and Antoine Leenhardt 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 = "2018",

month = oct,

day = "1",

doi = "10.1016/j.hrthm.2018.06.019",

language = "English",

volume = "15",

pages = "1457--1465",

journal = "Heart Rhythm",

issn = "1547-5271",

publisher = "Elsevier",

number = "10",

}

TY - JOUR

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

T2 - Data from a survey on arrhythmic events in 678 patients

AU - Milman, Anat

AU - Gourraud, Jean Baptiste

AU - Andorin, Antoine

AU - Postema, Pieter G.

AU - Sacher, Frederic

AU - Mabo, Philippe

AU - Conte, Giulio

AU - Giustetto, Carla

AU - Sarquella-Brugada, Georgia

AU - Hochstadt, Aviram

AU - Kim, Sung Hwan

AU - Juang, Jimmy J.M.

AU - Maeda, Shingo

AU - Takahashi, Yoshihide

AU - Kamakura, Tsukasa

AU - Aiba, Takeshi

AU - Leshem, Eran

AU - Michowitz, Yoav

AU - Rahkovich, Michael

AU - Mizusawa, Yuka

AU - Arbelo, Elena

AU - Huang, Zhengrong

AU - Denjoy, Isabelle

AU - Wijeyeratne, Yanushi D.

AU - Napolitano, Carlo

AU - Brugada, Ramon

AU - Casado-Arroyo, Ruben

AU - Champagne, Jean

AU - Calo, Leonardo

AU - Tfelt-Hansen, Jacob

AU - Priori, Silvia G.

AU - Takagi, Masahiko

AU - Veltmann, Christian

AU - Delise, Pietro

AU - Corrado, Domenico

AU - Behr, Elijah R.

AU - Gaita, Fiorenzo

AU - Yan, Gan Xin

AU - Brugada, Josep

AU - Leenhardt, Antoine

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 - 2018/10/1

Y1 - 2018/10/1

N2 - 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 ≈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 (≈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 do males. 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.

AB - 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 ≈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 (≈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 do males. 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.

KW - Brugada ECG

KW - Ethnicity

KW - Implantable cardioverter-defibrillatorEthnicity

KW - SCN5A mutation

KW - Sudden cardiac death

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U2 - 10.1016/j.hrthm.2018.06.019

DO - 10.1016/j.hrthm.2018.06.019

M3 - Journal article

C2 - 29908370

AN - SCOPUS:85052113959

SN - 1547-5271

VL - 15

SP - 1457

EP - 1465

JO - Heart Rhythm

JF - Heart Rhythm

IS - 10

ER -

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

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