Clinical Characteristics of Female Patients with Brugada Syndrome in Japanese Multi-center Study
Masahiko Takagi, M.D., Ph.D, Yasuhiro Yokoyama, M.D., Kazutaka Aonuma, M.D. ,Ph.D, Naohiko Aihara, M.D., and Masayasu Hiraoka, M.D.,Ph.D.,FAHA.,FACC. for the Japan Idiopathic Ventricular Fibrillation Study (J-IVFS)Investigators
Brugada syndrome is highly predominated in male and clinical features are characterized mainly by such population. It is unknown how the gender difference affects clinical phenotypes of Brugada syndrome. The aim of the present study is to examine clinical feature of Brugada syndrome in female patients.
A total of 216 consecutive patients with Brugada syndrome (53±14 years, 202 males, J wave amplitude >0.2mV and either coved or saddle-back type ST segment elevation in leads V1 and/or V2) were enrolled in the Japan Idiopathic Ventricular Fibrillation Study (J-IVFS) during February 2002 and February 2006. Following parameters were evaluated and compared between male and female patients: age, clinical symptoms (aborted sudden cardiac death (SCD), documented VF and unknown syncope), spontaneous or drug (Na channel blocker)-induced coved-type ECG, family history of SCD, familial incidences in Brugada-type ECG signs, history of paroxysmal atrial fibrillation (PAF), positive late potential (LP) in signal-averaged ECG, and inducibility of sustained ventricular tachyarrhythmias (VT/VF) by programmed ventricular stimulation.
The proportion of female patients was low (6.5%). There were no significant gender difference as to age, spontaneous or drug-induced coved-type ECG, history of PAF, and positive LP. Incidences in symptoms (50 and 21 % [p<0.05], male v.s. female, respectively) and inducibility of sustained VT/VF (86 and 60 % [p<0.05], male v.s. female, respectively) were significantly lower in female patients. Family history of SCD and/or familial incidences in Brugada-type ECG signs tended to be higher in female than in male, but not significant (12 and 29 % [p=0.07], male v.s. female, respectively).
The proportion of female patients with Brugada syndrome is lower in Japan than that in US-European countries. The known factors as markers of poor prognosis, such as the incidence of a previous history of VF and/or syncope and inducibility of VT/VF, appeared to be less frequently associated in female patients.
Female patients with Brugada syndrome may have a lower risk of sudden cardiac death than male patients.