Dual phenotypic transmission in Brugada syndrome

Arch Cardiovasc Dis. 2013 Jun-Jul;106(6-7):366-72. doi: 10.1016/j.acvd.2013.04.007. Epub 2013 Jun 28.

Abstract

Background: Brugada syndrome is a genetic heart disease with autosomal dominant inheritance. Family screening commonly detects one parent responsible for transmission of the disease.

Aims: To describe atypical transmission of Brugada syndrome.

Methods: Between 2001 and 2007, systematic screening, including an electrocardiogram, ajmaline challenge and DNA sequencing of the SCN5A gene, of the first-degree relatives of 62 probands with Brugada syndrome was performed (Programme Hospitalier de Recherche Clinique).

Results: In two families, both parents transmitted Brugada syndrome to their offspring. In the first family, the proband presented Brugada electrocardiogram features with ajmaline challenge and carried a new SCN5A mutation (p.V1281F). The mutation was also identified in the mother, who had a type 1 aspect on inferior leads with ajmaline. The proband's father presented a typical Brugada electrocardiogram pattern on lead V2 with ajmaline and no SCN5A gene mutation. In the second family, the proband was a boy aged 2.5 years who had been resuscitated from sudden cardiac death. Ajmaline challenge revealed a typical Brugada electrocardiogram pattern in both parents but with no mutation in the genes studied.

Conclusion: Family studies should always be exhaustive and discovery of one parent with Brugada syndrome does not eliminate the need for screening of the other parent.

Keywords: BS; Brugada syndrome; ECG; LQTS; Phenotype; Phénotype; SCN5A mutation; Syndrome de Brugada; electrocardiogram; long QT syndrome.

MeSH terms

  • Adolescent
  • Adult
  • Ajmaline
  • Anti-Arrhythmia Agents
  • Brugada Syndrome / complications
  • Brugada Syndrome / diagnosis
  • Brugada Syndrome / genetics*
  • Brugada Syndrome / therapy
  • Child, Preschool
  • DNA Mutational Analysis
  • Death, Sudden, Cardiac / etiology
  • Death, Sudden, Cardiac / prevention & control
  • Electrocardiography
  • Electrophysiologic Techniques, Cardiac
  • Female
  • Genetic Carrier Screening
  • Genetic Predisposition to Disease
  • Genetic Testing / methods
  • Heredity
  • Heterozygote*
  • Humans
  • Male
  • Mutation*
  • NAV1.5 Voltage-Gated Sodium Channel / genetics*
  • Pedigree
  • Phenotype
  • Predictive Value of Tests
  • Resuscitation
  • Young Adult

Substances

  • Anti-Arrhythmia Agents
  • NAV1.5 Voltage-Gated Sodium Channel
  • SCN5A protein, human
  • Ajmaline