Key result
Positive late potentials showed a nonsignificant association with fatal arrhythmic events in patients with Brugada syndrome (RR 2.06; 95% CI 0.98-4.36; P=0.06).
Why the study?
Risk stratification in Brugada syndrome remains challenging, motivating a summary of evidence on whether late potentials can predict arrhythmic events.
Does the presence of late potentials on SAECG predict fatal arrhythmic events in patients with Brugada syndrome?
Meta-Analysis (n=1,431)
Does the presence of late potentials on SAECG predict fatal arrhythmic events in patients with Brugada syndrome?
The presence of late potentials on signal-averaged ECG showed a nonsignificant trend toward predicting fatal arrhythmic events in patients with Brugada syndrome, indicating that current literature remains inconclusive.
Risk stratification of patients with Brugada syndrome (BrS) remains challenging. Signal-averaged electrocardiogram (SAECG) is a noninvasive tool that can be used to identify the electrophysiologic substrate potentially underlying fatal ventricular arrhythmias. The aim of this meta-analysis is to summarize the existing evidence about the role of late potentials (LP) as a predictor for arrhythmic events in patients with BrS. A systematic search in the MedLine database through to June 2022 without any limitations was performed. Ten studies were included in the quantitative synthesis (1431 patients with BrS, mean age 47.4 years, males 86%). Of these, 1220 patients underwent SAECG evaluation (53.2% had positive LP, and 20.6% had a fatal arrhythmic event). There was a nonsignificant association between positive LPs and fatal arrhythmic events [RR: 2.06 (0.98-4.36), P = 0.06, I 2 = 82%]. By including only studies with patients without a history of fatal arrhythmia, the association between LP with arrhythmic events remained nonsignificant [RR: 1.29 (0.67-2.48), P = 0.44, I 2 = 54%]. In conclusion, there is a possible association between LP and fatal arrhythmic events in patients with BrS, but the literature remains inconclusive. Large cohort studies using a multiparametric approach for risk stratification purposes are needed to improve the risk stratification of BrS and to optimize the selection of BrS patients that should be referred for implantable cardioverter-defibrillator.
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Bazoukis et al. (2023) conducted a meta-analysis in Brugada syndrome (n=1,431). Positive late potentials (LP) vs. Negative late potentials was evaluated on Fatal arrhythmic events (RR 2.06, 95% CI 0.98-4.36, p=0.06). Positive late potentials showed a nonsignificant association with fatal arrhythmic events in patients with Brugada syndrome (RR 2.06; 95% CI 0.98-4.36; P=0.06).
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