Brugada syndrome ECG is highly prevalent in schizophrenia

Marieke T. Blom, Dan Cohen, Adrie Seldenrijk, Brenda W.J.H. Penninx, Giel Nijpels, Coen D.A. Stehouwer, Jacqueline M. Dekker, Hanno L. Tan*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background-The causes of increased risk of sudden cardiac death in schizophrenia are not resolved. We aimed to establish (1) whether ECG markers of sudden cardiac death risk, in particular Brugada-ECG pattern, are more prevalent among patients with schizophrenia, and (2) whether 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 patients with schizophrenia, 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 the fndings with nonschizophrenic individuals of comparable age (the Netherlands Study of Depression and Anxiety [NESDA] cohort; N=179) and, to account for assumed increased aging rate in schizophrenia, with individuals 20 years older (Hoorn cohort; n=1168), using multivariate regression models. Brugada-ECG was signifcantly more prevalent in the schizophrenia cohort (11.6%) compared with NESDA controls (1.1%) or Hoorn controls (2.4%). Moreover, patients with schizophrenia had longer QT-intervals (410.9 versus 393.1 and 401.9 ms; both P<0.05), increased proportion of mild or severe QTc prolongation (13.1% and 5.8% versus 3.4% and 0.0% [NESDA], versus 5.1 and 2.8% [Hoorn]), and higher heart rates (80.8 versus 61.7 and 68.0 beats per minute; both P<0.05). The prevalence of Brugada-ECG was still increased (9.6%) when patients with schizophrenia without sodium channel-blocking medication were compared with either of the control cohorts. Conclusions-Brugada-ECG has increased prevalence among patients with schizophrenia. This association is not explained by the use of sodium channel-blocking medication.

Original languageEnglish
Pages (from-to)384-391
Number of pages8
JournalCirculation. Arrhythmia and Electrophysiology
Volume7
Issue number3
DOIs
Publication statusPublished - Jun 2014

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