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Sodium channels dysfunction in Brugada Syndrome (BS) predisposes to ventricular arrhythmias. The same mechanism is thought to be also responsible for a higher predisposition to atrial arrhythmias. So, is hypothesized that atrial fibrillation (AF) may be part of clinical manifestations in BS patients, possibly associated with higher level of channel dysfunction. Aims: To evaluate if documented AF episodes before BS diagnosis are associated with poorer prognosis, namely arrhythmic events and conduction cardiac system disease. Methods: Prospective study. 278 patients with BS have been included. Two groups were established: A, with patients with documented AF episodes (previous or at the time of BS diagnosis) (n=14); and B, composed by those without documented AF episodes at the time of BS diagnosis (n=264). Syncope and ventricular tachycardia/fibrillation (VT/ VF) events incidence during follow-up was evaluated, as well as cardiac conduction system disease incidence. Results: Patients from group A were older (54.4 ± 14.3 vs 43.1 ± 14.0, p=0.004), and were more frequently the “proband” (100% vs 76.9%, p=0.045). Mutations in gene SCN5A were identified in similar proportions (28.5% vs 21.6, p=ns) among those who were genotyped. Previous syncope and episodes of VT/VF incidences were not significantly different at the time of inclusion (42.9% vs 20.8%, p=0.09) and (7.1% vs 4.5%, p=ns), respectively. End points incidences during a follow-up of 59.3 ± 49.4 months are shown in table 1. At multivariate analysis, documented AF before BS diagnosis was an independent predictor of future syncope or VF/VT events

Atrial fibrillation as a marker of clinical severity in brugada syndrome