| Title | New-onset atrial fibrillation as first clinical manifestation of latent Brugada syndrome: prevalence and clinical significance. | | Author(s) | Pappone C, Radinovic A, Manguso F, Vicedomini G, Sala S, Sacco FM, Ciconte G, Saviano M, Ferrari M, Sommariva E, Sacchi S, Ciaccio C, Kallergis EM, Santinelli V | | Institution | Division of Electrophysiology and Cardiac Pacing, Department of Cardiology, San Raffaele University Hospital, Via Olgettina 60, 20132 Milan, Italy. | | Source | Eur Heart J 2009 Aug 20. | | Abstract | 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 results Between 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. Conclusion This 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. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19696190 |
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