Brugada electrocardiograms and Brugada Syndrome in Brunei Darussalam.

  

Bee Ngo LAU, Nazar LUQMAN, Sofian JOHAR

Division of Cardiology, Department of Medicine, RIPAS Hospital, Brunei Darussalam

 

 

ABSTRACT

Introduction: Patients with Brugada syndrome have structurally normal hearts but are susceptible to ventricular tachyarrhythmia and sudden cardiac death. Brugada syndrome is divided into three types based on the electrocardiograms (ECGs) changes and clinical symptoms. This study reviews the clinical profile of patients with Brugada ECGs and Brugada syndrome seen in a tertiary referral centre. Materials and Methods: All patients who attended the Cardiology Unit of RIPAS hospital between March 2006 and February 2011, and found to have Brugada electrocardiograms (ECGs) were included in the study. The clinical and follow-up data of these patients were obtained through detailed medical records review. Asymptomatic patients with intermittent Brugada Type I ECG and Brugada Type II or III ECG underwent provocative testing with oral flecainide, a class 1c antiarrhythmic. Symptomatic patients referred to patients with aborted sudden death or syncope at time of diagnosis and underwent electrophysiological study (EPS). Results: There were 24 patients (mean age of 42.2 ± 11.1 years, range 29 to 59 years) were identified during the study period with majority male (n=19, 79%) and Malay (n=17, 70.8%) population. Seven (19.2%) patients had Brugada Type I, eight (33.3%) Type II and nine (37.5%) Type III changes. Seven patients presented with symptoms but four (16.7%) fulfilled the criteria for Brugada Syndrome, giving an estimated prevalence of 1 per 100,000 population. Symptoms were common in those with Type I changes and none in those with Type II changes. Fleccainide were done in 21 patients and was positive in 10 (47.6%), again mostly in those with Type I changes. EPS were done in eight patients (Type I changes, n=6 and Type II, n=2). Two patients had induced VF and VT respectively, all with Type I changes. The remaining four had no inducible changes. ICD were implanted in four patients all, with positive EPS studies. There were no death recorded during the study period. Conclusions: Brugada ECGs and Brugada Syndrome are seen in approximately 1 per 100,000 population affecting the different racial and ethnic groups. However, it is likely to be under-recognised and underestimated given that most are patients asymptomatic and detected incidentally.

 

Keywords:  Arrhythmia, Brugada syndrome, sudden cardiac death, tachyarrhythmia

 

Correspondence author: Bee Ngo LAU, Division of Cardiology, Department of Medicine, RIPAS Hospital, Bandar Seri Begawan BA1710, Brunei Darussalam

Tel: +673 2242424 Ext  260

E mail: bee_lau@hotmail.com

 

 

Brunei Int Med J. 2014; 10 (2): 72-77

 

 

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