Journal Article

Homozygous SCN5A mutation in Brugada syndrome with monomorphic ventricular tachycardia and structural heart abnormalities

Gianfranco Frigo, Alessandra Rampazzo, Barbara Bauce, Kalliopi Pilichou, Giorgia Beffagna, Gian Antonio Danieli, Andrea Nava and Bortolo Martini

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 9, issue 6, pages 391-397
Published in print June 2007 | ISSN: 1099-5129
Published online April 2007 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1093/europace/eum053
Homozygous SCN5A mutation in Brugada syndrome with monomorphic ventricular tachycardia and structural heart abnormalities

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Aims

To describe a patient showing monomorphic ventricular tachycardia, ECG aspect of Brugada syndrome, and structural heart abnormalities due to a homozygous missense mutation in SCN5A.

Methods and results

Thirteen subjects (six males, seven females, mean age 46 ± 22 years) belonging to the same family underwent physical examination, basal biochemical marker detection, 12-lead ECG, Holter ECG, signal-averaged ECG, echocardiogram and genetic analysis. The proband underwent a stress test together with left and right ventricular angiography and electrophysiological study. Three subjects (the proband, his mother, and one brother) showed on ECG an ST-segment elevation in the right precordial leads with coved type aspect. Moreover, the proband presented a sustained monomorphic ventricular tachycardia (left bundle branch block aspect with superior axis), whereas all other family members were asymptomatic. Imaging techniques documented right ventricular structural abnormalities only in the proband. Mutation screening in SCN5A gene was performed in the proband and in available family members. The proband carries a novel SCN5A mutation, R814Q, in homozygous, whereas the parents and four siblings were heterozygous carriers of the same mutation.

Conclusion

This study provides the first evidence of a homozygous missense mutation in SCN5A associated with atypical ventricular arrhythmias and right structural abnormalities.

Keywords: Brugada syndrome; SCN5A gene; Ventricular tachycardia; Right ventricular abnormalities

Journal Article.  3020 words.  Illustrated.

Subjects: Cardiovascular Medicine

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