Arrhythmias & electrophysiology
The role for ambulatory electrocardiogram monitoring in the diagnosis and prognostication of Brugada syndrome: a sub-study of the Rare Arrhythmia Syndrome Evaluation (RASE) Brugada study
Authors' conclusion
Repeated ECG evaluation and HPL ambulatory monitoring are vital in identifying transient spT1 Brugada pattern and its associated risk.
Study context
- Population
- Brugada syndrome subjects with high precordial lead (HPL) resting and ambulatory monitoring electrocardiogram (ECGs)
- Participants
- 358 subjects
- Exposure
- spT1 pattern at presentation vs none
- Group 1n = 77
- Group 2n = 281reference
- Outcome
- Identification of spT1 on repeat HPL resting and ambulatory ECG, and its association with ventricular dysrhythmias and sudden cardiac death (SCD)
- Follow-up
- Median 72 months
Methodological detailssub-study of the RASE Brugada study, 1651 resting HPL and 621 ambulatory monitoring ECGs reviewed
- Sub-study of the RASE Brugada study
- 1651 resting HPL and 621 ambulatory monitoring ECGs reviewed
Main finding
As reported in the abstract
spT1 detection during follow-up · median 72 months (IQR 75)
| Group | Value | Newly detected spT1 rate | spT1 on HPL ambulatory recording |
|---|---|---|---|
| Group 1 | 55% | ||
| Group 2 | 13% | 1.9 per 100 person-year | 23 (8%) |
Value
Group 155%
Group 213%
Newly detected spT1 rate
Group 1Not reported in the abstract
Group 21.9 per 100 person-year
spT1 on HPL ambulatory recording
Group 1Not reported in the abstract
Group 223 (8%)
Observational data: associations, not effects.
Further findings
Arrhythmic events by spT1
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| spT1 at presentationUnivariate | 6.3 (1.4–28) | P = 0.016 | |
| spT1 at follow-upUnivariate | 3.1 (1.3–7.2) | P = 0.008 | |
| 0.050.21520Hazard ratio (log scale) |
- Arrhythmic events by spT1 — Previously asymptomatic subjects with arrhythmic events (5 with spT1)
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Original publication
The role for ambulatory electrocardiogram monitoring in the diagnosis and prognostication of Brugada syndrome: a sub-study of the Rare Arrhythmia Syndrome Evaluation (RASE) Brugada study. Europace. Published 8 April 2024. doi:10.
Summarised from the published abstract; every number is checked against it