Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease (Aug 2016)

Long‐Term Prognosis of Brugada‐Type ECG and ECG With Atypical ST‐Segment Elevation in the Right Precordial Leads Over 20 Years: Results From the Circulatory Risk in Communities Study (CIRCS)

  • Hidekazu Tsuneoka,
  • Masahiko Takagi,
  • Nobuyuki Murakoshi,
  • Kazumasa Yamagishi,
  • Yasuhiro Yokoyama,
  • DongZhu Xu,
  • Yukio Sekiguchi,
  • Hiro Yamasaki,
  • Yoshihisa Naruse,
  • Yoko Ito,
  • Miyako Igarashi,
  • Akihiko Kitamura,
  • Takeo Okada,
  • Takeshi Tanigawa,
  • Keisuke Kuga,
  • Tetsuya Ohira,
  • Hiroshi Tada,
  • Kazutaka Aonuma,
  • Hiroyasu Iso,
  • Tomoko Sankai,
  • Mitsumasa Umesawa,
  • Choy‐Lye Chei,
  • Kimiko Yokota,
  • Minako Tabata,
  • Hironori Imano,
  • Renzhe Cui,
  • Ai Ikeda,
  • Hiroyuki Noda,
  • Satoyo Ikehara,
  • Isao Muraki,
  • Yuji Shimizu,
  • Yoshinori Ishikawa,
  • Masahiko Kiyama,
  • Masakazu Nakamura,
  • Kenji Maeda,
  • Masatoshi Ido,
  • Masamitsu Konishi,
  • Takashi Shimamoto,
  • Minoru Iida,
  • Yoshio Komachi,
  • Shinichi Sato,
  • Yoshihiko Naito,
  • Hideki Ozawa,
  • Isao Saito,
  • Susumu Sakurai,
  • Shinichi Hitsumoto,
  • Masayuki Yao

DOI
https://doi.org/10.1161/JAHA.115.002899
Journal volume & issue
Vol. 5, no. 8

Abstract

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BackgroundBrugada syndrome is recognized as being associated with sudden cardiac death; however, the prevalence of non–type 1 Brugada‐type ECG (BrS) or atypical ST‐segment elevation in the right precordial leads (STERP) and the long‐term prognosis for those patients remain unknown. Methods and ResultsWe analyzed standard 12‐lead ECGs of 7178 apparently healthy participants (age range 40–64 years) who underwent health checkups from 1982 to 1986 in the Circulatory Risk in Communities Study, a prospective, large, community‐based cohort study in Japan. ECGs with J point amplitude ≥0.2 mV in the right precordial leads were divided into 3 groups: (1) type 1 BrS, (2) type 2 or 3 BrS (non‐type 1 BrS), and (3) STERP. The others served as the non–ST‐segment elevation group. We identified 8 participants (0.1%) with type1 BrS, 84 (1.2%) with non–type 1 BrS, and 228 (3.2%) with STERP. During a median follow‐up of 18.7 years (133 987.0 person‐years), sudden cardiac death was observed in no participants (0.0%) with type 1 BrS, in 1 (1.2%) with non–type 1 BrS, in 7 (3.1%) with STERP, and in 50 (0.7%) with non–ST‐segment elevation. Participants with STERP had a markedly elevated risk of sudden cardiac death (multivariable hazard ratio 3.9, 95% CI 1.7–9.0). ConclusionsSTERP was associated with an elevated risk of sudden cardiac death in a middle‐aged population.

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