Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.
Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.
JACC Clin Electrophysiol. 2017 Jan;3(1):57-67. doi: 10.1016/j.jacep.2016.04.004. Epub 2016 Jun 1.
This study investigated clinical characteristics and prognosis of Brugada syndrome (BrS) in patients older than 60 years of age during a long-term follow-up period.
Clinical characteristics and prognosis of senior patients with BrS have not been clearly elucidated.
A total of 181 patients with BrS were divided into 2 groups by age at the time of diagnosis: the younger group was <60 years of age (n = 123), and the senior group was ≥60 years of age (n = 58).
Mean ages were 42.7 ± 11 years and 68.6 ± 7.1 years, respectively. Prevalence of spontaneous type 1 electrocardiogram (ECG) was lower in the senior group (22 of 58; 37.9%) than in the younger group (64 of 123; 51.9%) (p = 0.027). Among various ECG parameters, the senior group had a lower incidence of prolonged r-J intervals in V ≥90 ms than the younger group (34 of 58; 58.6% vs. 90 of 123; 73.1%, p = 0.049) and day-to-day variation of Brugada ECG patterns (3 of 58; 5.2% vs. 23 of 123; 18.7%, p = 0.032). During a mean follow-up period of 7.6 ± 5.8 years, no senior patients experienced documented fatal ventricular arrhythmias, but 11 younger patients did. Kaplan-Meier analysis revealed a better prognosis in the senior group than in the younger group (log-rank, p = 0.011).
Senior BrS patients, ≥60 years of age, had a better prognosis than those <60 years of age. Implantable cardioverter-defibrillator insertion for senior patients with BrS needs careful consideration.
本研究旨在探讨 Brugada 综合征（BrS）老年患者（60 岁以上）的临床特征和预后。
老年 BrS 患者的临床特征和预后尚未明确。
将 181 例 BrS 患者按诊断时的年龄分为 2 组：年龄较轻组（<60 岁，n=123）和年龄较大组（≥60 岁，n=58）。
平均年龄分别为 42.7±11 岁和 68.6±7.1 岁。年龄较大组（58 例中 22 例，37.9%）自发性 1 型心电图（ECG）的发生率低于年龄较轻组（123 例中 64 例，51.9%）（p=0.027）。在各种 ECG 参数中，年龄较大组 r-J 间期延长在 V≥90ms 的发生率低于年龄较轻组（58 例中 34 例，58.6%比 123 例中 90 例，73.1%，p=0.049），且 Brugada 心电图模式的日间变化（58 例中 3 例，5.2%比 123 例中 23 例，18.7%，p=0.032）。在平均 7.6±5.8 年的随访期间，没有年龄较大组患者发生有记录的致命性室性心律失常，但年龄较轻组有 11 例。Kaplan-Meier 分析显示年龄较大组的预后优于年龄较轻组（对数秩检验，p=0.011）。
年龄较大（≥60 岁）的 BrS 患者预后优于年龄较轻（<60 岁）的患者。对于年龄较大的 BrS 患者，植入式心脏复律除颤器的置入需要仔细考虑。
