Supraventricular tachyarrhythmia in patients with Brugada syndrome: A single-center study

Background: Brugada syndrome is a distinct form of idiopathic ventricular fibrillation. We retrospectively investigated the incidence and clinical implications of supraventricular tachyarrhythmia in patients with Brugada syndrome. Methods: We reviewed 69 consecutive cases of Brugada syndrome, 11 of which had a history of syncope. Results: Seven patients (10.1%) had clinically documented supraventricular tachyarrhythmia: 3 patients with atrioventricular reentrant tachycardia, 2 with atrioventricular nodal reentrant tachycardia, and 2 with paroxysmal atrial fibrillation. The prevalence of a spontaneous type 1 Brugada electrocardiogram and symptoms (history of syncope, presyncope, documented ventricular tachyarrhythmia, or aborted sudden cardiac death) were significantly higher, and QRS duration was significantly longer in patients without than in those with supraventricular tachyarrhythmia. The PR and AH intervals were also longer in patients without than in those with supraventricular tachyarrhythmia, but the differences were not statistically significant. Conclusion: The arrhythmogenic substrate in Brugada syndrome may not be restricted to the ventricles. Palpitations in patients with this syndrome should raise the question of supraventricular tachyarrhythmia. Conversely, in patients with supraventricular tachyarrhythmia and aborted sudden cardiac death or syncope not related to supraventricular tachyarrhythmia, Brugada syndrome should be considered a possible additional electrophysiologic abnormality.