JACC
HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
QUICK SEARCH:   [advanced]


     

J Am Coll Cardiol, 2008; 51:1169-1175, doi:10.1016/j.jacc.2007.10.060
© 2008 by the American College of Cardiology Foundation
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow View CVN Genuine Article
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Related articles in JACC
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (1)
Google Scholar
Right arrow Articles by Kusano, K. F.
Right arrow Articles by Ohe, T.
PubMed
Right arrow Articles by Kusano, K. F.
Right arrow Articles by Ohe, T.

MINI-FOCUS ISSUE: BRUGADA SYNDROME: CLINICAL RESEARCH

Atrial Fibrillation in Patients With Brugada Syndrome

Relationships of Gene Mutation, Electrophysiology, and Clinical Backgrounds

Kengo F. Kusano, MD*, Makiko Taniyama, MD, Kazufumi Nakamura, MD, Daiji Miura, PhD, Kimikazu Banba, MD, Satoshi Nagase, MD, Hiroshi Morita, MD, Nobuhiro Nishii, MD, Atsuyuki Watanabe, MD, Takeshi Tada, MD, Masato Murakami, MD, Kohei Miyaji, MD, Shigeki Hiramatsu, MD, Koji Nakagawa, MD, Masamichi Tanaka, MD, Aya Miura, MD, Hideo Kimura, MD, Soichiro Fuke, MD, Wakako Sumita, MD, Satoru Sakuragi, MD, Shigemi Urakawa, MD, Jun Iwasaki, MD and Tohru Ohe, MD, FACC

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

Manuscript received September 19, 2007; accepted October 19, 2007.

* Reprint requests and correspondence: Dr. Kengo F. Kusano, Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Shikata-cho 2-5-1, Okayama 7008558, Japan. (Email: kusanokengo{at}hotmail.com).

Objectives: The goal of our work was to examine the relationships of atrial fibrillation (AF) with genetic, clinical, and electrophysiological backgrounds in Brugada syndrome (BrS).

Background: Atrial fibrillation is often observed in patients with BrS and indicates that electrical abnormality might exist in the atrium as well as in the ventricle. SCN5A, a gene encoding the cardiac sodium channel, has been reported to be causally related to BrS. However, little is known about the relationships of atrial arrhythmias with genetic, clinical, and electrophysiological backgrounds of BrS.

Methods: Seventy-three BrS patients (49 ± 12 years of age, men/women = 72/1) were studied. The existence of SCN5A mutation and clinical variables (syncopal episode, documented ventricular fibrillation [VF], and family history of sudden death) were compared with spontaneous AF episodes. Genetic and clinical variables were also compared with electrophysiologic (EP) parameters: atrial refractory period, interatrial conduction time (CT), repetitive atrial firing, and AF induction by atrial extra-stimulus testing.

Results: Spontaneous AF occurred in 10 (13.7%) of the BrS patients and SCN5A mutation was detected in 15 patients. Spontaneous AF was associated with higher incidence of syncopal episodes (60.0% vs. 22.2%, p < 0.03) and documented VF (40.0% vs. 14.3%, p < 0.05). SCN5A mutation was associated with prolonged CT (p < 0.03) and AF induction (p < 0.05) in EP study, but not related to the spontaneous AF episode and other clinical variables. In patients with documented VF, higher incidence of spontaneous AF (30.8% vs. 10.0%, p < 0.05), AF induction (53.8% vs. 20.0%, p < 0.03), and prolonged CT was observed.

Conclusions: Spontaneous AF and VF are closely linked clinically and electrophysiologically in BrS patients. Patients with spontaneous AF have more severe clinical backgrounds in BrS. SCN5A mutation is associated with electrical abnormality but not disease severity.

Abbreviations and Acronyms
  AF = atrial fibrillation
  BrS = Brugada syndrome
  CS = coronary sinus
  CT = conduction time
  EP = electrophysiology/electrophysiological
  ERP = effective refractory period
  FH = family history of sudden death
  ICD = implantable cardioverter-defibrillator
  PCR = polymerase chain reaction
  RAA = right atrial appendage
  RAF = repetitive atrial firing
  SCN5A = pore-forming region of the human cardiac sodium channel
  VF = ventricular fibrillation


Related articles in JACC:

The Brugada Syndrome
Peng-Sheng Chen and Silvia G. Priori
JACC 2008 51: 1176-1180. [Full Text]  



This article has been cited by other articles:


Home page
 JWatch Emergency Med.Home page
Brugada Syndrome: Association Between AF and VF
Journal Watch Emergency Medicine, May 9, 2008; 2008(509): 2 - 2.
[Full Text]

Home page
 J Am Coll CardiolHome page
P.-S. Chen and S. G. Priori
The Brugada Syndrome
J. Am. Coll. Cardiol., March 25, 2008; 51(12): 1176 - 1180.
[Full Text] [PDF]


HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
Copyright © 2008 by the American College of Cardiology Foundation.