Validation of Novel Risk Prediction Models in Patients with Brugada Syndrome: A Multicenter Study in Japan

BACKGROUND Risk stratification in patients with Brugada syndrome (BrS) is challenging, especially in those at intermediate risk. The Predicting Arrhythmic evenT (PAT) score has recently been demonstrated to be excellent for predicting future arrhythmic events in patients without prior ventricular fibrillation (VF). However, validation studies are lacking. OBJECTIVE This study aimed to assess the performance of a novel risk stratification model in predicting future VF events in patients with BrS in a Japanese multicenter cohort. METHODS The PAT score was calculated for 413 patients with BrS (mean age, 50.9±13.6 years; 395 men) from 59 hospitals in Japan, including 314 patients without prior VF. The incidence of developing VF during the follow‐up period was investigated. RESULTS During the 106.8-month follow-up period, 54 patients (13.1%) experienced VF events. Of the 314 patients without prior VF at enrollment, 14 (4.5%) experienced VF events. The incidence of VF events during the follow-up period was significantly higher in patients with PAT scores ≥10 than in those with scores <10 (41/173 [23.7%] vs. 13/240 [5.4%], p<0.0001) in the total cohort. No difference was observed in the incidence of VF events between patients with PAT scores ≥10 and <10 among the 314 patients without prior VF (6/86 [7.0%] vs. 8/228 [3.5%], p=0.22). PAT scores ≥10 predicted future VF events with a sensitivity and specificity of 42.9% and 73.3%, respectively. CONCLUSION This Japanese multicenter registry demonstrated that the novel risk stratification model could not accurately predict future VF events in patients with BrS, but without prior VF.