An Open Invitation to Join the International Brugada Electrocardiographic Indices Registry

Background:The Brugada Electrocardiographic Indices Registry is a comprehensive data registry composed of patients with Brugada patterns on the electrocardiogram(ECG).The aim is to test the hypotheses that(i)ECG indices combining both depolarization and repolarization abnormalities can better predict spontaneous ventricular arrhythmias than existing ECG markers in Brugada syndrome and(ii)that serial ECG measurements will provide additional information for risk stratifi cation,especially in asymptomatic patients.Methods:Patients with both Brugada pattern ECGs and Brugada syndrome are eligible for inclusion in this registry.Baseline characteristics and ECG variables refl ecting depolarization and repolarization will be determined.The primary outcome is spontaneous ventricular tachycardia/ventricular fi brillation or sudden cardiac death.Secondary outcomes are inducible ventricular tachycardia/ventricular fi brillation and syncope.Results:As of November 15,2019,39 investigators from 32 cities in 18 countries had joined this registry.As of December 15,2019,1383 cases had been enrolled.Conclusions:The Brugada Electrocardiographic Indices Registry will evaluate the disease life course,risk factors,and prognosis in a large series of Brugada patients.It will therefore provide insights for improving risk stratification.

The impact of post-operative atrial fibrillation on outcomes in coronary artery bypass graft and combined procedures

BACKGROUND Postoperative atrial fibrillation(POAF)is a common yet understudied clinical issue after coronary artery bypass graft(CABG)leading to higher mortality rates and stroke.This systematic review and metaanalysis evaluated the rates of adverse outcomes between patients with and without POAF in patients treated with CABG or combined procedures.METHODS The search period was from the beginning of PubMed and Embase to May 18th,2020 with no language restrictions.The inclusion criteria were:(1)studies comparing new onset atrial fibrillation before or after revascularization vs.no new onset AF before or after revascularization.The outcomes assessed included allcause mortality,cardiac death,cerebral vascular accident(CVA),myocardial infarction(MI),repeated revascularization,major adverse cardiac event(MACE),and major adverse cardiac and cerebrovascular events(MACCEs).RESULTS Of the 7,279 entries screened,11 studies comprising of 57,384 patients were included.Compared to nonPOAF,POAF was significantly associated with higher risk of allcause mortality(Risk Ratio(RR)=1.58;95%Confidence Interval(CI):1.42−1.76,P<0.00001)with accompanying high level of heterogeneity(I^(2)=62%).Conclusions Patients with POAF after CABG or combined procedures are at an increased risk of allcause mortality or CVAs.Therefore,POAF after such procedures should be closely monitored and treated judiciously to minimize risk of further complications.While there are studies on POAF versus no POAF on outcomes,the heterogeneity suggests that further studies are needed.