Recognition and clinical implications of high prevalence of migraine in patients with Brugada syndrome and drug‐induced type 1 Brugada pattern
Makaleler > Tam Makale · 2020
Yazarlar: Can HASDEMİR, Figen GÖKÇAY, Mehmet Nurullah ORMAN, Umut Kocabas, Serdar Payzin, Hatice ŞAHİN, Dale R Nyholt, Charles Antzelevitch
Journal of Cardiovascular Electrophysiology, Uluslararası, Wos, 2020, cilt 31, ss 3311-3317
DOI: 10.1111/jce.14778
Özet
Abstract Introduction We have previously reported high 1‐year prevalence of migraine in patients with atrial arrhythmias associated with DI‐type 1 BrP. The present study was designed to determine the lifetime prevalence of migraine in patients with Brugada syndrome (BrS) or drug‐induced type 1 Brugada pattern (DI‐type 1 BrP) and control group, to investigate the demographic and clinical characteristics, and to identify clinical variables to predict underlying BrS/DI‐type 1 BrP among migraineurs. Methods and Results Lifetime prevalence of migraine and migraine characteristics were compared between probands with BrS/DI‐type 1 BrP (n = 257) and control group (n = 370). Lifetime prevalence of migraine was 60.7% in patients with BrS/DI‐type 1 BrP and 30.3% in control group (p = 3.6 × 10−14). On stepwise regression analysis, familial migraine (odds ratio [OR] of 4.4; 95% confidence interval [CI]: 2.0–9.8; p = 1.3 × 10−4), vestibular migraine (OR of 5.4; 95% CI: 1.4–21.0); p = .013), migraine with visual aura (OR of 1.8; 95% CI: 1.0–3.4); p = .04) and younger age‐at‐onset of migraine (OR of 0.95; 95% CI: 0.93–0.98); p = .004) were predictors of underlying BrS/DI‐type 1 BrP among migraineurs. Use of anti‐migraine drugs classified as “to be avoided” or “preferably avoided” in patients with BrS and several other anti‐migraine drugs with potential cardiac INa/ICa channel blocking properties was present in 25.6% and 26.9% of migraineurs with BrS/DI‐type 1 BrP, respectively. Conclusion Migraine comorbidity is common in patients with BrS/DI‐type 1 BrP. We identify several clinical variables that point to an underlying type‐1 BrP among migraineurs, necessitating cautious use of certain anti‐migraine drugs.