Authors: Cinzia Monaco, Karim Benali, Maria Cespon-Fernandez, Xavier Bouteiller, Alvise Del Monte, Luigi Pannone, Elodie Surget, Giuseppe Mascia, Pasquale Notarstefano, Roberto Menè, Karim Kneizeh, Masateru Yokoyama, Marion Arnaud, Konstantinos Vlachos, Kenji Nakasone, Liesbeth Verhaeghe, Jennifer L Fitzgerald, Ashley Plant, Domenico Della Rocca, Alexandre Cathala, Stephane Samson, Juan Sieira, Remi Tixier, Josselin Duchateau, Thomas Pambrun, Giulio Conte, Gian Battista Chierchia, Meleze Hocini, Italo Porto, Nicolas Derval, Patrizio Mazzone, Frederic Sacher, Pierre Jaïs, Pedro Brugada, Carlo de Asmundis, Michel Haïssaguerre; Bordeaux Electrophysiology Investigators

Published in: Heart Rhythm (June 2025, Online ahead of print)

Publication Date: Published online June 20, 2025

Abstract

Background: Brugada syndrome is primarily associated with polymorphic ventricular arrhythmias, but monomorphic ventricular tachycardia (MVT) presentations are rarely documented.

Objective: To compare clinical presentations of Brugada syndrome patients experiencing monomorphic versus polymorphic ventricular arrhythmias.

Methods: Multicenter prospective study analyzing 793 ICD patients with Brugada syndrome.

Results: Among the cohort, 54 patients met inclusion criteria, showing 47 VF episodes and 27 MVT episodes. MVT patients demonstrated older age at onset, prolonged QRS duration, greater syncope prevalence, and broader epicardial substrate abnormalities compared to VF/PVT groups. Rapid rhythms were more frequent before MVT than VF, with lower ectopy incidence.

Conclusion: The study reveals distinct clinical phenotypes between MVT and VF presentations in Brugada syndrome, with MVT associated with more extensive substrate abnormalities.

Links:
• PubMed: https://pubmed.ncbi.nlm.nih.gov/40544903/
• DOI: 10.1016/j.hrthm.2025.06.025