A meta-analytic review of prevalence for Brugada ECG patterns and the risk for death

Xiao-Qing Quan, Song Li, Rui Liu, Kai Zheng, Xiao-Fen Wu, Qiang Tang, Xiao-Qing Quan, Song Li, Rui Liu, Kai Zheng, Xiao-Fen Wu, Qiang Tang

Abstract

Background: The prevalence of Brugada ECG pattern (BrEP) is different in different regions, and its mean prevalence over the world is unknown. The risk of people with BrEP for death remains unknown. We performed a meta-analysis to determine the prevalence of BrEP and risk ratio (RR) for death.

Methods: Relevant studies published between July 1, 2000 and August 20, 2016, which contain prevalence and RR for all-cause death and cardiac death, were included. The prevalence and RR are analyzed using meta-analysis.

Results: We finally retrieved 24 studies of the prevalence for BrEP and 5 studies of the RR for all-cause death and cardiac death. The worldwide mean prevalence of BrEP is 0.4%, with highest in Asia (0.9%) and lowest in North America (0.2%). Additionally, the mean prevalence in male is 0.9%, whereas it is 0.1% in female. The RR of BrEP for all-cause death is 0.78 (95% confidence interval 0.45-1.37), and for cardiac death it is 0.92 (95% confidence interval 0.23-3.66).

Conclusion: The prevalence of BrEP is about 0.4% around the world with different prevalence in region and sex. Our study shows that BrEP may not be taken as a predictor of all-cause death and cardiac death.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flow diagram of literature search and study selection.
Figure 2
Figure 2
Result of the mean global prevalence of Brugada ECG pattern (BrEP).
Figure 3
Figure 3
Result of the risk ratio (RR) of Brugada ECG pattern (BrEP) for all-cause death.
Figure 4
Figure 4
Result of the risk ratio (RR) of Brugada ECG pattern (BrEP) for cardiac death.

References

    1. Brugada P, Brugada J. Right bundle branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome. A multicenter report. J Am Coll Cardiol 1992;20:1391–6.
    1. Brugada P. Brugada syndrome: more than 20 years of scientific excitement. J Cardiol 2016;67:215–20.
    1. Zheng J, Zhou F, Su T, et al. The biophysical characterization of the first SCN5A mutation R1512W identified in Chinese sudden unexplained nocturnal death syndrome. Medicine (Baltimore) 2016;95:e3836.
    1. Chen Z, Mu J, Chen X, et al. Sudden unexplained nocturnal death syndrome in central China (Hubei): a 16-year retrospective study of autopsy cases. Medicine (Baltimore) 2016;95:e2882.
    1. Adler A. Brugada syndrome: diagnosis, risk stratification, and management. Curr Opin Cardiol 2016;31:37–45.
    1. Berne P, Brugada J. Brugada syndrome 2012. Circ J 2012;76:1563–71.
    1. Priori SG, Wilde AA, Horie M, et al. HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes: document endorsed by HRS, EHRA, and APHRS in May 2013 and by ACCF, AHA, PACES, and AEPC in June 2013. Heart Rhythm 2013;10:1932–63.
    1. Bayes de Luna A, Brugada J, Baranchuk A, et al. Current electrocardiographic criteria for diagnosis of Brugada pattern: a consensus report. J Electrocardiol 2012;45:433–42.
    1. Chung EH. Brugada ECG patterns in athletes. J Electrocardiol 2015;48:539–43.
    1. Gehi AK, Duong TD, Metz LD, et al. Risk stratification of individuals with the Brugada electrocardiogram: a meta-analysis. J Cardiovasc Electrophysiol 2006;17:577–83.
    1. Xu R, Ding S, Zhao Y, et al. Autologous transplantation of bone marrow/blood-derived cells for chronic ischemic heart disease: a systematic review and meta-analysis. Can J Cardiol 2014;30:1370–7.
    1. Ding S, Du YP, Lin N, et al. Effect of glucagon-like peptide-1 on major cardiovascular outcomes in patients with type 2 diabetes mellitus: a meta-analysis of randomized controlled trials. Int J Cardiol 2016;222:957–62.
    1. Ding S, Xu L, Yang F, et al. Association between tissue characteristics of coronary plaque and distal embolization after coronary intervention in acute coronary syndrome patients: insights from a meta-analysis of virtual histology-intravascular ultrasound studies. PLoS One 2014;9:e106583.
    1. Lyu T, Zhao Y, Zhang T, et al. Natriuretic peptides as an adjunctive treatment for acute myocardial infarction: insights from the meta-analysis of 1,389 patients from 20 trials. Int Heart J 2014;55:8–16.
    1. Lyu T, Zhao Y, Zhang T, et al. Effect of statin pretreatment on myocardial perfusion in patients undergoing primary percutaneous coronary intervention: a systematic review and meta-analysis. Clin Cardiol 2013;36:E17–24.
    1. Yeung HM, Hung MW, Lau CF, et al. Cardioprotective effects of melatonin against myocardial injuries induced by chronic intermittent hypoxia in rats. J Pineal Res 2015;58:12–25.
    1. Hermida JS, Lemoine JL, Aoun FB, et al. Prevalence of the brugada syndrome in an apparently healthy population. Am J Cardiol 2000;86:91–4.
    1. Monroe MH, Littmann L. Two-year case collection of the Brugada syndrome electrocardiogram pattern at a large teaching hospital. Clin Cardiol 2000;23:849–51.
    1. Viskin S, Fish R, Eldar M, et al. Prevalence of the Brugada sign in idiopathic ventricular fibrillation and healthy controls. Heart 2000;84:31–6.
    1. Furuhashi M, Uno K, Tsuchihashi K, et al. Prevalence of asymptomatic ST segment elevation in right precordial leads with right bundle branch block (Brugada-type ST shift) among the general Japanese population. Heart 2001;86:161–6.
    1. Miyasaka Y, Tsuji H, Yamada K, et al. Prevalence and mortality of the Brugada-type electrocardiogram in one city in Japan. J Am Coll Cardiol 2001;38:771–4.
    1. Junttila MJ, Raatikainen MJ, Karjalainen J, et al. Prevalence and prognosis of subjects with Brugada-type ECG pattern in a young and middle-aged Finnish population. Eur Heart J 2004;25:874–8.
    1. Blangy H, Sadoul N, Coutelour JM, et al. [Prevalence of Brugada syndrome among 35,309 inhabitants of Lorraine screened at a preventive medicine centre]. Arch Mal Coeur Vaiss 2005;98:175–80.
    1. Shin SC, Ryu HM, Lee JH, et al. Prevalence of the Brugada-type ECG recorded from higher intercostal spaces in healthy Korean males. Circ J 2005;69:1064–7.
    1. Oe H, Takagi M, Tanaka A, et al. Prevalence and clinical course of the juveniles with Brugada-type ECG in Japanese population. Pacing Clin Electrophysiol 2005;28:549–54.
    1. Bozkurt A, Yas D, Seydaoglu G, et al. Frequency of Brugada-type ECG pattern (Brugada sign) in Southern Turkey. Int Heart J 2006;47:541–7.
    1. Ito H, Yano K, Chen R, et al. The prevalence and prognosis of a Brugada-type electrocardiogram in a population of middle-aged Japanese-American men with follow-up of three decades. Am J Med Sci 2006;331:25–9.
    1. Bigi MA, Aslani A, Shahrzad S. Prevalence of Brugada sign in patients presenting with palpitation in southern Iran. Europace 2007;9:252–5.
    1. Letsas KP, Gavrielatos G, Efremidis M, et al. Prevalence of Brugada sign in a Greek tertiary hospital population. Europace 2007;9:1077–80.
    1. Kui C, Congxin H, Xi W, et al. Characteristic of the prevalence of J wave in apparently healthy Chinese adults. Arch Med Res 2008;39:232–5.
    1. Gallagher MM, Forleo GB, Behr ER, et al. Prevalence and significance of Brugada-type ECG in 12,012 apparently healthy European subjects. Int J Cardiol 2008;130:44–8.
    1. Gervacio-Domingo G, Isidro J, Tirona J, et al. The Brugada type 1 electrocardiographic pattern is common among Filipinos. J Clin Epidemiol 2008;61:1067–72.
    1. Tsuji H, Sato T, Morisaki K, et al. Prognosis of subjects with Brugada-type electrocardiogram in a population of middle-aged Japanese diagnosed during a health examination. Am J Cardiol 2008;102:584–7.
    1. Wajed A, Aslam Z, Abbas SF, et al. Frequency of Brugada-type ECG pattern (Brugada sign) in an apparently healthy young population. J Ayub Med Coll Abbottabad 2008;20:121–4.
    1. Patel SS, Anees S, Ferrick KJ. Prevalence of a Brugada pattern electrocardiogram in an urban population in the United States. Pacing Clin Electrophysiol 2009;32:704–8.
    1. Pecini R, Cedergreen P, Theilade S, et al. The prevalence and relevance of the Brugada-type electrocardiogram in the Danish general population: data from the Copenhagen City Heart Study. Europace 2010;12:982–6.
    1. Schukro C, Berger T, Stix G, et al. Regional prevalence and clinical benefit of implantable cardioverter defibrillators in Brugada syndrome. Int J Cardiol 2010;144:191–4.
    1. Juang JM, Phan WL, Chen PC, et al. Brugada-type electrocardiogram in the Taiwanese population: is it a risk factor for sudden death? J Formos Med Assoc 2011;110:230–8.
    1. Uhm JS, Hwang IU, Oh YS, et al. Prevalence of electrocardiographic findings suggestive of sudden cardiac death risk in 10,867 apparently healthy young Korean men. Pacing Clin Electrophysiol 2011;34:717–23.
    1. Juang JM, Chen CY, Chen YH, et al. Prevalence and prognosis of Brugada electrocardiogram patterns in an elderly Han Chinese population: a nation-wide community-based study (HALST cohort). Europace 2015;17(Suppl 2):ii54–62.
    1. Brugada R, Campuzano O, Sarquella-Brugada G, et al. Brugada syndrome. Methodist Debakey Cardiovasc J 2014;10:25–8.
    1. Antzelevitch C, Brugada P, Borggrefe M, et al. Brugada syndrome: report of the second consensus conference. Heart Rhythm 2005;2:429–40.
    1. Postema PG. About Brugada syndrome and its prevalence. Europace 2012;14:925–8.
    1. Atarashi H, Ogawa S, Harumi K, et al. Characteristics of patients with right bundle branch block and ST-segment elevation in right precordial leads. Idiopathic Ventricular Fibrillation Investigators. Am J Cardiol 1996;78:581–3.
    1. Brugada J, Brugada R, Brugada P. Right bundle-branch block and ST-segment elevation in leads V1 through V3: a marker for sudden death in patients without demonstrable structural heart disease. Circulation 1998;97:457–60.
    1. Nademanee K, Veerakul G, Nimmannit S, et al. Arrhythmogenic marker for the sudden unexplained death syndrome in Thai men. Circulation 1997;96:2595–600.
    1. Priori SG, Napolitano C, Gasparini M, et al. Clinical and genetic heterogeneity of right bundle branch block and ST-segment elevation syndrome: a prospective evaluation of 52 families. Circulation 2000;102:2509–15.

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