SPC365

QRS duration and frequent PVC: additional features in Brugada Syndrome stratification

Session: Posters (Sessão 2 - Écran 2) - Arritmias 2 - Arritmias Ventriculares 1
Speaker: Joana Brito

Congress: CPC 2022
Topic: C. Arrhythmias and Device Therapy
Theme: 08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
Subtheme: 08.3 Ventricular Arrhythmias and SCD - Diagnostic Methods
Session Type: Pósters Electrónicos
FP Number: ---
Authors: Joana Brito; Pedro Silvério António; Beatriz Valente Silva; Pedro Alves da Silva; Sara Couto Pereira; Gustavo Silva; Afonso Nunes Ferreira; Ana Paixão; Nuno Cortez-Dias; Fausto j. Pinto; João de Sousa

<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Introduction:</strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Brugada syndrome (BrS) is a channelopathy with high prevalence of malignant arrhythmic events. The risk stratification in patients (pts) with Brugada electrocardiographic (ECG) pattern is of major importance, to prevent sudden cardiac death (SCD). A higher risk is evidenced in spontaneous type 1 pattern when compared with induced type-1 pattern, as so other electrocardiographic features have been explored aiming to detect additional prognostic factors.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Purpose:</strong></span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"> To evaluate the association of QRS duration and frequent premature ventricular contractions (PVC) with malignant arrhythmic events.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Methods:</strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Prospective single-center study of consecutive pts with BrS, with spontaneous or induced type 1 pattern included from 2003 to 2021. All pts were enrolled in a protocol including annual non-invasive assessment with ECG and 24-hours Holter monitoring. Primary endpoints were defined as SCD or appropriate shocks in the context of ventricular tachycardia or fibrillation (VT/FV) during follow-up. Cox regression and Kaplan-Meier survival analyses were used to determine the association between the baseline ECG and Holter characteristics and the long-term risk of arrhythmic events.</span></span></span></p>

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<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Results:</strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">A total of 117 pts was included, 75 (65%) with a spontaneous type 1 pattern and 44 (33%) with an induced type 1 pattern. The mean age was 47&plusmn;13years and 38 (32.5%) were male.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">During a median follow-up of 4.1&plusmn;0.3 years, the primary endpoint occurred in 8 (6.8%) pts, with sudden cardiac death in 3 (2.6%) and appropriate shocks due to VT/FV in 5 (4.3%). Pts who suffered arrhythmic events had presented at the study inclusion higher QRS duration (124&plusmn;18 vs. 108&plusmn;16ms, p= 0.014) and more frequent PVCs on 24-hour Holter (169&plusmn;297 vs. 29&plusmn;198; p = 0.001). Indeed, the presence of QRS &ge;119ms was associated with a 7-fold higher risk (HR: 7.250, 95% CI 1.619-32.461, p = 0.010) and the presence of more than 6 PVC on 24-hour Holter was also associated with a 5-fold higher risk of malignant arrhythmic events (HR 5.376, 95% 1.186-24.260, p = 0.029).&nbsp;</span></span></span></p>

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<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Conclusion:</strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">QRS duration and frequent PVC may established themselves as additional risk factors.&nbsp; In our cohort, they were both predictors of arrhythmic events during follow-up and thus can further complement BrS risk stratification.</span></span></span></p>

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