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American Journal of Cardiology

Clinical Articles, News & Views

AF as early sign of Brugada syndrome

Atrial fibrillation (AF) could be one of the first clinical manifestations of latent Brugada syndrome (BS) in a considerable number of patients, according to a study1 published recently in the American Journal of Cardiology.

Researchers investigated a patient group consisting of 611 patients with BS. The data from those with a diagnosis of AF previous to the identification of BS were analysed (n = 35). 11 cases were unmasked after the initiation of a class I antiarrhythmic drug and one during the establishment of general anaesthesia. In the remaining population, BS was diagnosed using an ajmaline test performed mainly because of younger age in patients with lone AF (n = 13), previous syncope or sudden cardiac death (n = 3), or a clinical history of sudden cardiac death in the family (n = 5).

The mean patient age was 49 ± 15 years, 21 were male patients, 14 had a family history of sudden death, 15 had had previous syncope, and 4 had survived cardiac arrest. Concomitant electrical disorder was found in 13 patients. Remarkably, 21 patients had normal findings on the baseline electrocardiogram.

This identification is crucial because the treatment of these patients is subject to relevant changes. The ajmaline test plays an essential role, mainly in young patients with a family history of sudden death, despite having normal findings on a baseline electrocardiogram.


1. Rodríguez-Mañero M, Namdar M, Sarkozy A, et al. Prevalence, clinical characteristics and management of atrial fibrillation in patients with brugada syndrome. Am J Cardiol 2012.

Published on: January 25, 2013

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association

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