Age threshold of ventricular arrhythmia in patients with Brugada syndrome

Introduction Testosterone plays an important role for developing ventricular arrhythmia in Brugada syndrome. The testosterone level decreases with age. This study aimed to evaluation of age threshold of developing ventricular arrhythmia in patients with Brugada syndrome. Methods Total 68 male patients (age, 42.3 ± 14.9 years) who had an implantable cardioverter-defibrillator (ICD) for Brugada syndrome were included. Exclusion criteria were (1) female and (2) patients without ICD. ICDs were regularly interrogated 1 or 2 times per year during follow-up period. We analyzed relationship between (1) age and appropriate ICD therapy; (2) proportion of patients whose Brugada ECG pattern disappeared and (3) age and disappearance of Brugada ECG pattern. Results The patients were followed up until 66.2 ± 9.3 years old. Quinidine was administered in 17.6% of the patients. During 15.1 ± 5.9 years of follow-up, 0.7 ± 1.3 times of appropriate ICD therapies per person were delivered. Brugada ECG pattern disappeared in 53.8% of the patients with apparent (not provoked) Brugada ECG pattern. Brugada ECG pattern disappeared at the age of 66.2 ± 9.3 years old. The last appropriate ICD shock was delivered at the age of 50.1 ± 15.4 years old. No ventricular arrhythmia events developed in patients who were older than 65.2 years. Conclusion Brugada ECG pattern and development of ventricular arrhythmia can be associated with the age of patients with Brugada syndrome. We may consider to discontinue quinidine in patients older than 65 years whose Brugada ECG pattern disappears.