Gender Differences in Patients with Brugada Syndrome and Arrhythmic Events: Data from the Survey on Arrhythmic Events in 678 Patients With Brugada Syndrome (SABRUS) - The 65th Annual Conference of the Israel Heart Society & The Israel Society of Cardiothoracic Surgery, 24-25 April 2018

Anat Milman Department of Cardiology, Tel Aviv Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Jean-Baptiste Gourraud L'institut du Thorax, Service de Cardiologie, CHU de Nantes, Nantes, France Antoine Andorin L'institut du Thorax, Service de Cardiologie, CHU de Nantes, Nantes, France Pieter G. Postema Heart Centre AMC, Department of Clinical and Experimental Cardiology, AMC, University of Amsterdam, Amsterdam, The Netherlands Frederic Sacher Hôpital Cardiologique du Haut-Lévêque & Université Bordeaux, LIRYC Institute, Bordeaux, France Philippe Mabo Cardiology and Vascular Disease Division, Rennes University Health Centre, Rennes, France Giulio Conte Heart Rhythm Management Centre, UZ-VUB, Brussels, Belgium Carla Giustetto Division of Cardiology, University of Torino, Department of Medical Sciences, Città della Salute e della Scienza Hospital, Torino, Italy Georgia Sarquella-Brugada Pediatric Arrhythmias, Electrophysiology and Sudden Death Unit Cardiology, Department Hospital Sant Joan de Déu, Barcelona - Universitat de Barcelona, Spain Aviram Hochstadt Tel-Aviv Medical Center, Tel Aviv, Department of Internal Medicine J, Israel Sung-Hwan Kim Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea Jimmy JM Juang Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan Shingo Maeda Heart Rhythm Center, Tokyo Medical and Dental University, Tokyo, Japan Yoshihide Takahashi Heart Rhythm Center, Tokyo Medical and Dental University, Tokyo, Japan Tsukasa Kamakura Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan Takeshi Aiba Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan Eran Leshem Department of Cardiology, Tel Aviv Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA Yoav Michowitz Department of Cardiology, Tel Aviv Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Michael Rahkovich Department of Cardiology, Tel Aviv Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Arrhythmia Services,, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada Yuka Mizusawa Heart Centre AMC, Department of Clinical and Experimental Cardiology, AMC, University of Amsterdam, Amsterdam, The Netherlands Elena Arbelo Cardiology Department, Cardiovascular Institute, Hospital Clinic and IDIBAPS, Barcelona, Catalonia, Spain Zhengrong Huang Department of Cardiology, the First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China Isabelle Denjoy Service de Cardiologie et CNMR Maladies Cardiaques Héréditaires Rares, Hôpital Bichat, Paris, and Université Paris Diderot, Sorbonne, Paris, France Yanushi D. Wijeyeratne Cardiovascular Sciences, St. George's University of London and Cardiology Clinical Academic Group St. George's University Hospitals NHS Foundation Trust, London, UK Carlo Napolitano Molecular Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, Pavia,, Italy Ramon Brugada Cardiovascular Genetics Center, University of Girona-IDIBGI, Girona, Spain; Medical Science Department, School of Medicine, University of Girona, Girona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain Ruben Casado-Arroyo Department of Cardiology,, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium Jean Champagne Quebec Heart and Lung Institute, Quebec City, Canada Leonardo Calo Division of Cardiology, Policlinico Casilino, Roma, Italy Jacob Tfelt-Hansen Department of Forensic Medicine, Faculty of Medical Sciences, University of Copenhagen, Denmark Silvia G. Priori Molecular Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, Pavia,, Italy Masahiko Takagi Division of Cardiac Arrhythmia, Kansai Medical University Medical Center, Moriguchi, Japan Christian Veltmann Rhythmology and Electrophysiology, Department of Cardiology, Hannover Medical School, Hannover, Germany Pietro Delise Division of Cardiology,, Hospital of Peschiera del Garda, Veneto, Italy Domenico Corrado Department of Cardiac, Thoracic and Vascular Sciences University of Padova, Padova, Italy Elijah R. Behr Cardiovascular Sciences, St. George's University of London and Cardiology Clinical Academic Group St. George's University Hospitals NHS Foundation Trust, London, UK Fiorenzo Gaita Division of Cardiology, University of Torino, Department of Medical Sciences, Città della Salute e della Scienza Hospital, Torino, Italy Gan-Xin Yan Lankenau Medical Center, Wynnewood, Pennsylvania, USA Josep Brugada Cardiology Department, Cardiovascular Institute, Hospital Clinic and IDIBAPS, Barcelona, Catalonia, Spain Antoine Leenhardt Service de Cardiologie et CNMR Maladies Cardiaques Héréditaires Rares, Hôpital Bichat, Paris, and Université Paris Diderot, Sorbonne, Paris, France Arthur A.M. Wilde Heart Centre AMC, Department of Clinical and Experimental Cardiology, AMC, University of Amsterdam, Amsterdam, The Netherlands Pedro Brugada Heart Rhythm Management Centre, UZ-VUB, Brussels, Belgium Kengo F. Kusano Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan Kenzo Hirao Heart Rhythm Center, Tokyo Medical and Dental University, Tokyo, Japan Gi-Byoung Nam Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Africa Vincent Probst L'institut du Thorax, Service de Cardiologie, CHU de Nantes, Nantes, France Bernard Belhassen

Background

There is limited information on gender differences in patients with Brugada syndrome (BrS) who experienced arrhythmic events (AE).

Objectives

To compare clinical, electrocardiographic (ECG), electrophysiologic (EP) and genetic characteristics between males and females in a large cohort of BrS-patients with their first AE.

Methods

The multicenter Survey on AE in BrS (SABRUS) collected data on first AE in 678 BrS-patients including 619 (91.3%) males and 59 (8.7%) females aged 0.27 to 84 (mean 42.5±14.1) years at the time of the AE.

Results

Females and males presented their AE at similar ages (42.1±21.2 vs. 41.9±14 years, respectively); however, after excluding pediatric patients, females were older than males (49.5±14.4 vs. 43±12.7 years, respectively, P=0.001). Higher proportions of females were observed in the pediatric and elderly populations. In Asians, male/female ratio of AE was ≈9-fold higher compared to Caucasians. Females less frequently showed a spontaneous type-1 BrS-ECG (31% vs. 59%, P<0.001) or arrhythmia-inducibility at EP study (34% vs. 64%, P<0.001). An SCN5A mutation was more frequently found in females (47.6% vs. 27.8% in males, P=0.007). A high proportion of females (35% vs. 24% in males, P=0.25) underwent prophylactic ICD-implantation that subsequently proved to be justified (AE during follow up) despite not complying with current primary prevention guidelines.

Conclusions

This study confirms that female BrS-patients display less common risk factors for AE. It shows for the first time the complex relationship between gender distribution and patient ethnicity with the age at onset of AE as well as higher SCN5A mutation rates in females.