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EP News: Clinical

Published:November 04, 2021DOI:https://doi.org/10.1016/j.hrthm.2021.11.003
      Miles et al (J Am Coll Cardiol 2021;78:1511, PMID 34620408) evaluated the presence and distribution of ventricular myocardial fibrosis in a cohort of decedents experiencing sudden cardiac death caused by Brugada syndrome (BrS). The investigators evaluated 28 whole hearts from consecutive sudden cardiac death cases attributed to BrS and 29 hearts from a comparator group comprising noncardiac deaths (control subjects). Of 28 BrS decedents (75% men; median age of death 25 years), death occurred in sleep or at rest in 24 of 28 (86%). The highest proportion of collagen was observed in the epicardial right ventricular outflow tract of the BrS group (23.7%). Ventricular myocardium from BrS decedents demonstrated a higher proportion of collagen compared with control subjects (ratio 1.45; P < .001). The authors conclude that BrS is associated with increased collagen content throughout right and left ventricular myocardium, irrespective of sampling location or myocardial layer.
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