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Brugada Syndrome ECG Is Highly Prevalent in Schizophrenia.
Circ Arrhythm Electrophysiol. 2014 Mar 3;
Authors: Blom MT, Cohen D, Seldenrijk A, Penninx BW, Nijpels G, Stehouwer CD, Dekker JM, Tan HL
Abstract
BACKGROUND: -The causes of the increased risk of sudden cardiac death (SCD) in schizophrenia are not resolved. We aimed to establish whether 1) ECG markers of SCD-risk, in particular, Brugada-ECG pattern, are more prevalent among schizophrenia patients, 2) increased prevalence of these ECG markers in schizophrenia is explained by confounding factors, notably sodium-channel blocking medication.
METHODS AND RESULTS: -In a cross-sectional study, we analyzed ECGs of a cohort of 275 schizophrenia patients, along with medication use. We determined whether Brugada-ECG was present, and assessed standard ECG measures (heart rate, PQ-, QRS- and QT-intervals). We compared findings with non-schizophrenic individuals of comparable age (NESDA cohort, N=179), and, to account for assumed increased ageing-rate in schizophrenia, with 20-year older individuals (Hoorn cohort, n=1168), using multivariate regression models. Brugada-ECG was significantly more prevalent in the schizophrenia cohort (11.6%) compared with NESDA controls (1.1%) or Hoorn controls (2.4%). Moreover, schizophrenia patients had longer QT-intervals (410.9 vs. 393.1 and 401.9 msec, both p<0.05), an increased proportion of mild or severe QTc-prolongation (13.1% and 5.8% vs. 3.4% and 0.0% [NESDA], vs. 5.1 and 2.8%, [Hoorn]), and higher heart rates (80.8 vs. 61.7 and 68.0 beats per minute, both p<0.05). Prevalence of Brugada-ECG was still increased (9.6%) when schizophrenia patients without sodium-channel blocking medication were compared to either control cohort.
CONCLUSIONS: -Brugada-ECG has increased prevalence among schizophrenia patients. This association is not explained by use of sodium-channel blocking medication.
PMID: 24591540 [PubMed - as supplied by publisher]