Comparisons of clinical impacts on individuals with Brugada electrocardiographic patterns defined by ISHNE criteria or EHRA/HRS/APHRS criteria: a nationwide community-based study

Figures & data

Figure 1. Comparisons of the HRS/EHRA/APHRS 2013 and ISHNE 2012 Brugada syndrome ECG criteria. (A). HRS/EHRA/APHRS 2013: Type 1 ECG (coved type); type 2 ECG (saddleback type); type 3 ECG (saddleback with ST-segment elevation <1 mm). (B). ISHNE 2012: Type 1 ECG (coved pattern); type 2 ECG (saddleback pattern) with β angle >58°. ECG = electrocardiographic; HRS/EHRA/APHRS = Heart Rhythm Society/European Heart Rhythm Association/Asia-Pacific Heart Rhythm Society; ISHNE = International Society for Holter and Noninvasive Electrocardiography.

Figure 2. (A). An example of an excluded Brugada-type ECG pattern due to β angle <58° in a 74-year-old woman. (B). An example of an excluded Brugada-type ECG pattern due to J point elevation <0.2 mV in a 66-year-old man. (C). Difference in the numbers of individuals with Brugada-type ECG between 2013 HRS/EHRA/APHRS and 2012 ISHNE criteria. ECG = electrocardiographic; HRS/EHRA/APHRS = Heart Rhythm Society/European Heart Rhythm Association/Asia-Pacific Heart Rhythm Society; ISHNE = International Society for Holter and Noninvasive Electrocardiography.

Table 1. Demographic data and clinical outcomes of the study individuals.

	HRS/EHRA/APHRS 2013					ISHNE 2012
	Individuals with Type 1	Individuals with Type 2	Individuals with Type 3	Individuals without BrP	p-Value	Individualswith Type 1	Individuals with Type 2	Individuals without BrP	p-Value
Individuals, n	4	68	101	5041		4	46	5164
Prevalence, %	0.077	1.30	1.94	NA		0.077	0.88	NA
Men, n (%)	3 (75)	53 (78)	56 (55)	2418 (48)	<.001	3 (75)	36 (78)	2491 (48)	<.001
Age at enrolment, years	70.4 ± 5	67.7 ± 8	70.0 ± 8	69.3 ± 8	.31	70.4 ± 5	67.3 ± 8	69.3 ± 8	.22
Diabetes, n (%)	0	4 (6)	8 (8)	963 (19)	.001	0	4 (9)	971 (19)	.14
Hypertension, n (%)	1 (25)	21 (31)	37 (37)	2252 (45)	.04	1 (25)	12 (26)	2298 (45)	.03
Dyslipidemia, n (%)	0	11 (16)	32 (32)	1624 (32)	.02	0	5 (11)	1662 (32)	.003
Mean PR, ms	175 ± 5	173 ± 28	185 ± 189	173 ± 50	.18	175 ± 5	171 ± 25	173 ± 56	.97
Mean QRS, ms	107 ± 12	97 ± 11	98 ± 17	95 ± 15	.02	107 ± 12	96 ± 11	95 ± 15	.21
Mean QTc, ms	446 ± 51	429 ± 21	437 ± 22	439 ± 83	.78	446 ± 51	429 ± 20	439 ± 82	.69
Follow-up, months	37 ± 7	23 ± 15	29 ± 13	26 ± 14	.03	37 ± 7	21 ± 15	26 ± 14	.01
Annual event rate, %	0	0	0	0.005		0	0	0.005
All-cause mortality, n (%)	0	0	2(2)	139 (2.7)	.21	0	0	141 (2.7)	.29
CV death, n (%)	0	0	0	28 (0.5)	.24	0	0	28 (0.5)	.58

BrP: Brugada electrocardiographic pattern; CV: cardiovascular; HRS: Heart Rhythm Society; ISHNE: International Society for Holter and Noninvasive Electrocardiography; NA: not available.

Table 2. Comparisons of electrocardiographic parameters in the individuals with or without Brugada ECG pattern.

	HRS/EHRA/APHRS 2013			ISHNE 2012
	Individuals with BrP	Individuals without BrP	p-Value	Individuals with BrP	Individuals without BrP	p-Value
P, ms	111 ± 14	113 ± 33	.42	112 ± 12	113 ± 33	.79
PR, ms	180 ± 146	173 ± 50	.08	171 ± 24	173 ± 56	.84
QRS, ms	98 ± 15	95 ± 15	.003*	97 ± 11	95 ± 15	.24
QT, ms	417 ± 26	417 ± 116	.995	416 ± 26	417 ± 115	.94
QTc, ms	434 ± 23	439 ± 83	.44	430 ± 23	439 ± 82	.45
Heart rate, per minute	66 ± 9	68 ± 23	.10	65 ± 9	68 ± 23	.25
P-wave axis, degrees	57 ± 33	50 ± 30	.005*	62 ± 31	50 ± 31	.005*
QRS axis, degrees	23 ± 50	27 ± 37	.34	27 ± 47	27 ± 37	.96
T wave axis, degrees	43 ± 27	39 ± 32	.08	47 ± 22	39 ± 32	.08

BrP: Brugada ECG pattern; ECG: electrocardiographic; HRS: Heart Rhythm Society; ISHNE: International Society for Holter and Noninvasive Electrocardiography.

* p < .05.

Figure 3. Kaplan–Meier survival analysis between individuals with and without Brugada-type ECG patterns according to the criteria proposed by 2013 HRS/EHRA/APHRS and 2012 ISHNE. (A). All-cause mortality. (B). Cardiovascular mortality. ECG = electrocardiogram; HRS/EHRA/APHRS = Heart Rhythm Society/European Heart Rhythm Association/Asia-Pacific Heart Rhythm Society; ISHNE = International Society for Holter and Noninvasive Electrocardiography.

Figure 4. Among the individuals with type 2 or 3 ECG defined by 2013 HRS/EHRA/APHRS criteria, Kaplan–Meier survival analysis of all-cause mortality between the individuals fitting ISHNE 2012 criteria (*) and those not fitting (†). ECG = electrocardiogram.