Arrhythmias & electrophysiologyCohort study
Prevalence and Prognostic Significance of Exercise-Accentuated J-Point Elevation in Brugada Syndrome
- retrospective study
- single-center
- consecutive patients
- blinded review of tracings by two cardiologists
- Firth penalized logistic regression
Authors' conclusion
Exercise-induced accentuation of J-point elevation reproducibly identifies a subset of BrS patients at risk for exertional cardiac events. These findings support the inclusion of EST in the evaluation of patients with a clinical diagnosis or genetic susceptibility to BrS and may inform exercise-related risk counseling.
Study context
- Population
- Consecutive patients referred for Brugada syndrome (BrS) evaluation who underwent exercise stress testing (EST), January 1, 2000, through October 31, 2025consecutive patients referred for BrS evaluation who underwent EST · BrS1 cohort (type 1 BrS pattern) 95 · SCN5A cohort (without type 1 pattern but with loss-of-function SCN5A variants) 46
- Participants
- 141 patients
- Exposure
- Exercise-accentuated BrS phenotype vs its absence, for cardiac events
- Exercise-accentuated BrS phenotypen = 41
Main finding
As reported in the abstract
Overall cardiac events:
- Arrhythmic syncope
- Cardiac arrest
- Appropriate implantable cardioverter-defibrillator shocks
Estimate (CI)P value
Exercise-accentuated BrS phenotype
unadjusted OR 1.83(0.84–3.99)
P = 0.13Exercise-accentuated BrS phenotype
adjusted OR 1.22(0.47–3.21)
P = 0.69Observational data: associations, not effects.
Further findings
Exertion-triggered cardiac events
| Comparison | Estimate | P value | |
|---|---|---|---|
| Exercise-accentuated BrS phenotype | unadjusted OR 10.50 (CI 2.94–37.50) | P < 0.001 | |
| Exercise-accentuated BrS phenotype | adjusted OR 10.04 (CI 2.76–36.53) | P < 0.001 | |
| 0.050.21520Ratio (log scale) |
- Exertion-triggered cardiac events: independent of sex, exercise workload, and baseline type 1 pattern
Prevalence of exercise-accentuated BrS phenotype · near peak exercise
- Patients with exercise-accentuated BrS phenotype
- 41 patients (29%)
- Emergence, median age-predicted maximum heart rate
- median 90% age-predicted maximum heart rate
Reproducibility on serial testing
- Follow-up ESTs reproducing the phenotype
- 88% of follow-up ESTs
SCN5A variant-positive patients
- Consistent results were noted in SCN5A variant-positive patients
Original publication
Prevalence and Prognostic Significance of Exercise-Accentuated J-Point Elevation in Brugada Syndrome. JACC Clin Electrophysiol. Published 10 September 2026. doi:10.1016/j.jacep.2026.07.018
Summarised from the published abstract; every number is checked against it