Arrhythmias & electrophysiologyCohort study
Clinical Profile and Mode of Initiation of Spontaneous Ventricular Tachyarrhythmias in Patients With Brugada Syndrome (START-BrS)
- retrospective multicenter registry
Authors' conclusion
In this largest analysis to date of spontaneous VTA onset in BrS, MVT occurred in a substantial minority and was associated with older age, White ethnicity, drug-induced electrocardiogram pattern, and a preceding tachycardia. Initiation patterns were broadly similar across arrhythmia types, although PVT exhibited a significantly lower prematurity index and faster early cycle length despite only nonsignificant shorter coupling intervals. These findings refine the clinical and electrophysiological characterization of BrS-related arrhythmias and delineate distinct features of PVT and MVT initiation.
Study context
- Population
- Patients with Brugada syndrome with documented spontaneous ventricular tachyarrhythmia initiation captured by implantable cardioverter-defibrillator or electrocardiogramfrom 29 centers, 234 ventricular tachyarrhythmias (VTAs) analyzed
- Participants
- 154 patients
- Exposure
- clinical profile and mode of initiation of polymorphic ventricular tachycardia (PVT) and monomorphic ventricular tachycardia (MVT) in Brugada syndrome (BrS)
Main finding
As reported in the abstract
PVT
80.5% of patients
MVT
16.9%
both
2.6%
Observational data: associations, not effects.
Further findings
Coupling intervals initiating VTA
| Outcome | PVT | MVT |
|---|---|---|
| Pause-dependent initiation | approximately 25% of episodes | approximately 33% of episodes |
Clinical profile of patients with MVT
- Patients with MVT tended to be older, exhibit drug-induced Brugada electrocardiogram, and were more frequently White
Coupling intervals initiating VTA
- Coupling intervals initiating PVT nonsignificantly shorter than for MVT
Prematurity index and early arrhythmia cycle length
- PVT: significantly lower prematurity index and faster early arrhythmia cycle length than MVT
Antecedent premature ventricular complexes
- Present in both VTA types
- approximately 43%
- Commonly sharing morphology with the initiating premature ventricular complex
Pathogenic/likely pathogenic SCN5A mutation prevalence
- Did not differ between groups
Original publication
Summarised from the published abstract; every number is checked against it