Long-term prognosis of women with Brugada syndrome and electrophysiological study

Published:December 24, 2020DOI:


      A male predominance in Brugada syndrome (BrS) has been widely reported, but scarce information on female patients with BrS is available.


      The purpose of this study was to investigate the clinical characteristics and long-term prognosis of women with BrS.


      A multicenter retrospective study of patients diagnosed with BrS and previous electrophysiological study (EPS) was performed.


      Among 770 patients, 177 (23%) were female. At presentation, 150 (84.7%) were asymptomatic. Females presented less frequently with a type 1 electrocardiographic pattern (30.5% vs 55.0%; P <.001), had a higher rate of family history of sudden cardiac death (49.7% vs 29.8%; P <.001), and had less sustained ventricular arrhythmias (VAs) on EPS (8.5% vs 15.1%; P = .009). Genetic testing was performed in 79 females (45% of the sample) and was positive in 34 (19%). An implantable cardioverter-defibrillator was inserted in 48 females (27.1%). During mean (± SD) follow-up of 122.17 ± 57.28 months, 5 females (2.8%) experienced a cardiovascular event compared to 42 males (7.1%; P = .04). On multivariable analysis, a positive genetic test (18.71; 95% confidence interval [CI] 1.82–192.53; P = .01) and atrial fibrillation (odds ratio 21.12; 95% CI 1.27–350.85; P = .03) were predictive of arrhythmic events, whereas VAs on EPS (neither with 1 or 2 extrastimuli nor 3 extrastimuli) were not.


      Women with BrS represent a minor fraction among patients with BrS, and although their rate of events is low, they do not constitute a risk-free group. Neither clinical risk factors nor EPS predicts future arrhythmic events. Only atrial fibrillation and positive genetic test were identified as risk factors for future arrhythmic events.


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      Linked Article

      • Letter to the Editor—Electrophysiological study in women with Brugada Syndrome
        Heart RhythmVol. 18Issue 6
        • Preview
          The results of the study by Rodríguez-Mañero et al1 are in line with those reported by the two other most active groups in the field of Brugada syndrome (BrS).2,3 All three have confirmed the rare occurrence of malignant arrhythmic events (AEs), the lower prevalence of spontaneous type 1 BrS electrocardiogram (ECG), and the lower ventricular fibrillation (VF) inducibility rate in female patients with BrS. Similar to the Belgian2 and French3 reports, the Spanish study did not find that VF inducibility can be used for predicting arrhythmic risk in female patients.
        • Full-Text
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      • The top 10 reasons to avoid electrophysiology studies in Brugada syndrome
        Heart RhythmVol. 18Issue 5
        • Preview
          Most patients with Brugada syndrome (BS) who are asymptomatic at the time of diagnosis will remain so during follow-up. However, for 75% of those who actually become symptomatic, cardiac arrest will be their first clinical manifestation. Performance of electrophysiology studies (EPSs) is recommended to identify the few at risk, with the assumption that those with inducible ventricular fibrillation (VF) are those who will ultimately develop spontaneous VF.1 We present our reasons for avoiding this practice.
        • Full-Text
        • PDF