Low prevalence of Brugada-type electrocardiogram in a prospective large cohort of Egyptians

Background: Brugada syndrome is a cardiac channelopathy that is associated with a high risk of VF and SCD and characterized by ECG pattern of transient or persistent, coved type ST-segment elevation in leads V-1-V-3. Aim: To prospectively determine the prevalence of Brugada-type ECG pattern (Brugada sign) among unselected non cardiac individuals served at Cairo university teaching-hospital. Methods: This study was conducted from October 2011 to September 2012, and included 4000 unselected noncardiac individuals (2078 males 52%, mean age 39 +/- 14.44 years) admitted or presented to our hospital for different reasons. A 12-lead ECG was recorded for each of them; these ECGs were reviewed independently by two electrophysiologists for criteria of the three types of Brugada ECG pattern, and diagnosis of Brugada sign was made when both investigators agreed on the classification of the ECG findings according to the criteria of the Consensus Report of the Study Group of the Molecular Basis of Arrhythmia of the European Society of Cardiology. Results: Twenty-two (0.55%) subjects had Brugada ECG pattern. All of them were of Mediterranean ethnic group. 18 males (0.45%), and 4 females (0.1%). No subjects showed type-1, while 11 (0.275%) of the 22 subjects had type-2, and the other 11 had type-3 Brugada ECG pattern. Eight cases (0.2%) among the 22 subjects were between 10 and 24 years old. Of the 22 subjects, 4 cases (18.2%) were symptomatic (palpitation and syncope), and 3 cases (13%) had positive F.H of SCD. Conclusion: The frequency of type-1 Brugada-type ECG pattern was 0%, while type-2 and type-3 (saddleback type) was 0.55% among Egyptian hospital-based population, and it was more prevalent in middle-aged males. (C) 2013 Production and hosting by Elsevier B.V. on behalf of Egyptian Society of Cardiology.