Prevalence and Incidence of Type 1 Brugada Pattern: A 30-Year Experience at Mayo Clinic

Abstract

Objective: To identify the incidence and prevalence of type 1 Brugada pattern at Mayo Clinic during 30 years.

Methods: We retrospectively reviewed the electronic medical records from 1992 to 2021 at Mayo Clinic Enterprise. Patients with type 1 Brugada pattern electrocardiogram (ECG) were identified by a systematic keyword search. Incidences are calculated by decade. The incidence rate ratios (IRRs) between races were then calculated. Analysis of the association between groups and major arrhythmic event-free survival was conducted.

Results: The study analyzed 5,381,186 ECGs from 2,304,809 patients; 150 patients had at least 1 ECG with a type 1 Brugada pattern (76.0% Brugada syndrome, 62.0% spontaneous, 18.7% fever induced, and 10.7% drug induced). The mean follow-up was 6.6±6.7 years. The incidence (per 100,000 person-years) of type 1 Brugada pattern increased during the past 3 decades (0.505 [95% CI, 0.203 to 1.040], 3.015 [95% CI, 2.272 to 3.925], and 3.916 [95% CI, 3.128 to 4.842]). The incidence in Black patients was approximately 1.5-fold higher compared with non-Hispanic White patients (IRR, 1.492 [95% CI, 0.610 to 3.649]; P=.38). The incidence in Hispanic White patients was 3-fold higher than in non-Hispanic White patients (IRR, 3.021 [95% CI, 1.410 to 6.474]; P=.005). The incidence in Asian patients was 2-fold higher than in Hispanic patients (IRR, 1.894 [95% CI, 0.705 to 5.086]; P=.21). The overall prevalence of the type 1 Brugada pattern between 2010 and 2021 was 10.094 per 100,000. The major arrhythmic events occurred in 8.6%, 7.1%, 12.5%, and 7.7% for spontaneous, fever-induced, drug-induced, and other type 1 Brugada patterns, respectively, during follow-up.

Conclusion: The incidence of type 1 Brugada pattern at Mayo Clinic has increased during 3 decades. The prevalence of type 1 Brugada pattern in the United States is higher than previously reported. Type 1 Brugada pattern in Black and Hispanic populations is more common than previously suspected.