Prevalence of Brugada ECG pattern in patients with mood disorders: a longitudinal prospective cohort of 215 patients

Abstract Background Brugada syndrome (BrS) is an inherited disorder with autosomal dominant transmission, which occurs predominantly in males in the third to fourth decade of life with resting syncope, nocturnal agonic breathing, major ventricular arrhythmias and sudden death. Aim of the study: To evaluate the prevalence of Brugada ECG pattern in psychiatric patients with mood disorders. Methods from January 2023 to Decembre 2023, 215 consecutive patients with mood disorders who were admitted to the psychiatric department of the university hospital of our city were enrolled. For each patient, electrocardiographic and anamnestic data including psychiatric diagnosis, current drug therapy and family history were collected. Results Ten out of two-hundred and fifteen patients (4.6%) presented with a Brugada ECG pattern. Mean age was 37±10 years and eight out of ten patients (80%) were male. One patient exhibited a spontaneous type 1 Brugada ECG pattern meanwhile nine patients had a Brugada type 2 or 3 ECG pattern. When compared to the general mood disorder population, those with Brugada ECG had longer P wave duration (112±6 vs 103±13 msec p0.01). Evaluating mood disorders in BrS, there was a higher prevalence of unipolar vs bipolar disorders (90 vs 10%). There were no differences in term of sodium channel blocker drug prescription among mood disorders patients with or without BrS (5.7% vs 4.1%, p=0.65). Conclusions Brugada ECG pattern has a prevalence of 4.6% in a large cohort of psychiatric patients with mood disorders. Uni-polar disorder was the most common diagnosis in this cohort. Large prospective registries are needed to evaluate the clinical feature and potential clinical implication of this findings.