Ethnic differences in patients with Brugada syndrome and arrhythmic events: New insights from Survey on Arrhythmic Events in Brugada Syndrome

Anat Milman, Antoine Andorin, Pieter G. Postema, Jean Baptiste Gourraud, Frederic Sacher, Philippe Mabo, Sung Hwan Kim, Shingo Maeda, Yoshihide Takahashi, Tsukasa Kamakura, Takeshi Aiba, Giulio Conte, Jimmy J.M. Juang, Eran Leshem, Yoav Michowitz, Rami Fogelman, Aviram Hochstadt, Yuka Mizusawa, Carla Giustetto, Elena ArbeloZhengrong Huang, Domenico Corrado, Pietro Delise, Giuseppe Allocca, Masahiko Takagi, Yanushi D. Wijeyeratne, Andrea Mazzanti, Ramon Brugada, Ruben Casado-Arroyo, Jean Champagne, Leonardo Calo, Georgia Sarquella-Brugada, Camilla H. Jespersen, Jacob Tfelt-Hansen, Christian Veltmann, Silvia G. Priori, Elijah R. Behr, Gan Xin Yan, Josep Brugada, Fiorenzo Gaita, Arthur A.M. Wilde, Pedro Brugada, Kengo F. Kusano, Kenzo Hirao, Gi Byoung Nam, Vincent Probst, Bernard Belhassen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: There is limited information on ethnic differences between patients with Brugada syndrome (BrS) and arrhythmic events (AEs). Objective: The purpose of this study was to compare clinical, electrocardiographic (ECG), electrophysiological, and genetic characteristics between white and Asian patients with BrS and AEs. Methods: The Survey on Arrhythmic Events in Brugada Syndrome is a multicenter survey from Western and Asian countries, gathering 678 patients with BrS and first documented AE. After excluding patients with other (n = 14 [2.1%]) or unknown (n = 30 [4.4%]) ethnicity, 364 (53.7%) whites and 270 (39.8%) Asians comprised the study group. Results: There was no difference in AE age onset (41.3 ± 16.1 years in whites vs 43.3 ± 12.3 years in Asians; P = .285). Higher proportions of whites were observed in pediatric and elderly populations. Asians were predominantly men (98.1% vs 85.7% in whites; P < .001) and frequently presented with aborted cardiac arrest (71.1% vs 56%; P < .001). Asians tended to display more spontaneous type 1 BrS-ECG pattern (71.5% vs 64.3%; P = .068). A family history of sudden cardiac death was noted more in whites (29.1% vs 11.5%; P < .001), with a higher rate of SCN5A mutation carriers (40.1% vs 13.2% in Asians; P < .001), as well as more fever-related AEs (8.5% vs 2.9%; P = .011). No difference was observed between the 2 groups regarding history of syncope and ventricular arrhythmia inducibility. Conclusion: There are important differences between Asian and white patients with BrS. Asian patients present almost exclusively as male adults, more often with aborted cardiac arrest and spontaneous type 1 BrS-ECG. However, they have less family history of sudden cardiac death and markedly lower SCN5A mutation rates. The striking difference in SCN5A mutation rates should be tested in future studies.

Original languageEnglish
Pages (from-to)1468-1474
Number of pages7
JournalHeart Rhythm
Issue number10
StatePublished - Oct 2019


  • Arrhythmic event
  • Asian
  • Brugada syndrome
  • SCN5A mutation
  • White


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