Brugada syndrome in patients with acute febrile illness

Abstract

Background: Brugada syndrome (BrS) is an inherited electroclinical syndrome and can be occasionally precipitated by fever. The prevalence of Brugada-type electrocardiographic patterns (BTEP) due to febrile illnesses have not been previously studied in India. Materials and methods: Between June 2014 and December 2015, 525 consecutive patients admitted to a government hospital with acute febrile illness were retrospectively enrolled. In addition to their investigations for workup of fever, ECGs were analyzed and BTEP types 1 and 2 were noted. Daily ECGs if available were perused to document reversal. Results: BTEP was seen in 23 (4% 95%CI: 2.9–6.5%): BTEP type 1 (Brugada syndrome) in 11 patients (2%; 95%CI 1.2–3.7%) and BTEP type 2 in 12. All patients with BrS (BTEP type1) were males; mean age and temperature were 37.7 years (SD: 17.6) and 38.8 °C (SD: 0.6), respectively. There were no significant differences in age, temperature or ECG parameters between patients with BTEP and those without. These patients neither had cardiac symptoms nor family history of sudden cardiac deaths. Bacterial infections were the commonest cause of fever in patients with BrS. All BTEP changes resolved with defervesence of fever except in one. Conclusion: The prevalence of the fever induced BrS is higher in our study group and is comparable to estimates in Southeast Asian populations. An ECG should be considered in all febrile patients. Further studies are required for better characterization and risk stratification of these patients. Keywords: Brugada syndrome, Brugada-type ECG pattern, India, Fever, Prevalence