Worldwide prevalence of Brugada syndrome: A systematic review and meta-analysis

Background: Brugada syndrome (BrS) is considered to be an inherited arrhythmic disease associated with fatal complications and premature sudden unexpected death. The prevalence of the Brugada electrocardiogram pattern (BrP) has been reported in several countries. Nonetheless, the specific worldwide prevalence of BrS has not been reported. Objective: We estimated the worldwide prevalence of BrS and Type-2/3 BrP in general adult populations using a systematic review and meta-analysis of the existing literature. Methods: We thoroughly searched MEDLINE and SCOPUS databases up to March 2017. Included studies were population-based electrocardiogram studies in which prevalence was presented or could be calculated from available data. Pooled prevalence by country/region and/or ethnicitywas estimated using a random-effect model. Results: Twenty-eight articles with atotal population of 369,068 were included in this study. The worldwide pooled prevalence of BrS was 0.5 per 1,000 [95% confidence interval (CI): 0.3-0.7]. The highest prevalence was reported in Southeast Asia (1.8 per 1,000, 95% CI: 0.5-6.6); the lowestwas found in North Africa (0 per 1,000). BrS in Asianswas nine timesmore common than in Caucasians and 36 timesmore common than in Hispanics. The worldwide pooled prevalence of Type-2/3 BrPwas 6.1 per 1,000 (95% CI: 5.0-7.1). The highest prevalencewas also reported in Southeast Asia (35.5 per 1,000, 95% CI: 17.1-53.9). Conclusions: This study revealed a significant difference in the worldwide prevalence of BrS and Type-2/3 BrP. Brugada electrocardiogram patterns are highly prevalent in Southeast Asia.