AUTHOR=Lee Sharen , Wong Wing Tak , Wong Ian Chi Kei , Mak Chloe , Mok Ngai Shing , Liu Tong , Tse Gary 

TITLE=Ventricular Tachyarrhythmia Risk in Paediatric/Young vs. Adult Brugada Syndrome Patients: A Territory-Wide Study

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.671666

DOI=10.3389/fcvm.2021.671666

ISSN=2297-055X

ABSTRACT=<p><bold>Introduction:</bold> Brugada syndrome (BrS) is a cardiac ion channelopathy with a higher prevalence in Asia compared to the Western populations. The present study compared the differences in clinical and electrocardiographic (ECG) presentation between paediatric/young (≤25 years old) and adult (&gt;25 years) BrS patients.</p><p><bold>Method:</bold> This was a territory-wide retrospective cohort study of consecutive BrS patients presenting to public hospitals in Hong Kong. The primary outcome was spontaneous ventricular tachycardia/ventricular fibrillation (VT/VF).</p><p><bold>Results:</bold> The cohort consists of 550 consecutive patients (median age of initial presentation = 51 ± 23 years; female = 7.3%; follow-up period = 83 ± 80 months), divided into adult (<italic>n</italic> = 505, mean age of initial presentation = 52 ± 19 years; female = 6.7%; mean follow-up period = 83 ± 80 months) and paediatric/young subgroups (<italic>n</italic> = 45, mean age of initial presentation = 21 ± 5 years, female = 13.3%, mean follow-up period = 73 ± 83 months). The mean annual VT/VF incidence rate were 17 and 25 cases per 1,000 patient-year, respectively. Multivariate analysis showed that initial presentation of type 1 pattern (HR = 1.80, 95% CI = [1.02, 3.15], <italic>p</italic> = 0.041), initial asymptomatic presentation (HR = 0.26, 95% CI = [0.07, 0.94], <italic>p</italic> = 0.040) and increased P-wave axis (HR = 0.98, 95% CI = [0.96, 1.00], <italic>p</italic> = 0.036) were significant predictors of VT/VF for the adult subgroup. Only initial presentation of VT/VF was predictive (HR = 29.30, 95% CI = [1.75, 492.00], <italic>p</italic> = 0.019) in the paediatric/young subgroup.</p><p><bold>Conclusion:</bold> Clinical and ECG presentation of BrS vary between the paediatric/young and adult population in BrS. Risk stratification and management strategies for younger patients should take into consideration and adopt an individualised approach.</p>