We sought to investigate the value of a family history of sudden death (SD) in Brugada syndrome (BS).

Two hundred and eighty consecutive patients (mean age 41±18 years, 168 males) with diagnostic type I Brugada ECG pattern were included. Sudden death occurred in 69 (43%) of 157 families. One hundred and ten SDs were analyzed. During follow-up VF (ventricular fibrillation) or SD-free survival rate was not different between patients with or without a family history of SD of first-degree relative, between patients with or without a family history of multiple SD of a first- degree relative at any age and between patients with and without a family history of SD in first- degree relative <35 years. One patient had family history of SD of two first- degree relative < 35 years with arrhythmic event during follow-up. In univariate analysis male gender (P<0.001), and inducibility during electrophy-siological (EP) study (P<0.001) were associated with worse prognosis. The absence of syncope, aborted SD, spontaneous type I ECG, and inducibility during EP study was associated with a significantly better prognosis (P<0.001).

Family history of SD is not predictive for future arrhythmic events even if considering only SD in first-degree relatives or SD in first-degree relatives at a young age. The absence of syncope, aborted SD, spontaneous type I ECG, and inducibility during EP study is associated with a good five-year prognosis.