Skip Navigation



European Heart Journal Advance Access published online on August 20, 2009
European Heart Journal, doi:10.1093/eurheartj/ehp326
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Pappone, C.
Right arrow Articles by Santinelli, V.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Pappone, C.
Right arrow Articles by Santinelli, V.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

New-onset atrial fibrillation as first clinical manifestation of latent Brugada syndrome: prevalence and clinical significance

Carlo Pappone1,*, Andrea Radinovic1, Francesco Manguso1, Gabriele Vicedomini1, Simone Sala1, Francesco Maria Sacco1, Giuseppe Ciconte1, Massimo Saviano1, Maurizio Ferrari2, Elena Sommariva2, Stefania Sacchi1, Cristiano Ciaccio1, Eleftherios M. Kallergis1 and Vincenzo Santinelli1,*

1 Division of Electrophysiology and Cardiac Pacing, Department of Cardiology, San Raffaele University Hospital, Via Olgettina 60, 20132 Milan, Italy
2 Laboratory of Clinical Molecular Biology DIBIT 2, San Raffaele University Hospital, Milan, Italy

Received 21 October 2008; revised 6 July 2009; accepted 13 July 2009 * Corresponding author. Tel: +39 02 26437310, Fax: +39 02 26437326, Email: carlo.pappone{at}hsr.it (C.P.); vincenzo.santinelli{at}hsr.it

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.

Key Words: Brugada syndrome • Sudden cardiac death • Atrial fibrillation


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.