0197: Brugada syndrome in elderly patients

Introduction Brugada syndrome (BrS) is an inherited arrhythmia syndrome with an increased risk of syncope and sudden death. There is no report of BrS in people aged 65 years old or more. The aim of this study is to describe the clinical characteristics of BrS in elderly people. Methods BrS patients older than 65 years were recruited from 8 french tertiary centers. Clinical data investigation of family history, 12-lead ECG and results of pharmacological challenge were collected. Average follow-up was 78±48 months. Results 54 patients were recruited (mean age 69±4 years), 33/54 patients (61%) were male. The circumstances of diagnoses were: systematic ECG (n=23, 43%), symptoms (n=19, 35%) and familial screening (n=11, 20%). 25 patients (46%) were symptomatic: resuscitated sudden cardiac death (SCD) in 1 patient (1.8%), 12 syncope (22%), 3 supraventricular tachycardia (6%), 6 palpitation (11%) and 9 lipothymia (17%). 15 patients have history of familial SCD (28%). Implantable cardiac defibrillator (ICD) was implanted in 15/54 patients (28%) and 1 patient (1.8%) was implanted with pacemaker. At baseline, mean HR was 68±14 bpm, PR 190±50 mm, QRS 105±16 mm and QTc 422±43 mm. 29 patients (54%) have spontaneous type-1 ECG. Mean ST elevation were 3.4±1.5 mm. During follow-up only 1/54 patients (1.8%) has an arrhythmic event. This patient was symptomatic (syncope). 2 patients died but their death was not due to a cardiac cause. We compared our results to the patients aged under 65 years old of the FINGER BrS Registry (n=945 patients). The number of ICD implanted patients was higher in FINGER cohort (28 vs 42%). Patients of the FINGER cohort presented more arrhythmic events than patients aged 65 years or more in this study (5.2 vs 1.8%). Conclusion Patients aged more than 65 years old seem to represent a lower-risk group than patients aged under 65 years old. Further studies are needed in this population in order to identify risk factors in BrS patients aged more than 65 years old.