Brugada syndrome masked by complete left bundle branch block: A clinical and functional study of its association with the p.1449Y>H SCN5A variant

J Cardiovasc Electrophysiol. 2021 Oct;32(10):2785-2790. doi: 10.1111/jce.15215. Epub 2021 Sep 1.

Abstract

SCN5A gene variants are associated with both Brugada syndrome and conduction disturbances, sometimes expressing an overlapping phenotype. Functional consequences of SCN5A variants assessed by patch-clamp electrophysiology are particularly beneficial for correct pathogenic classification and are related to disease penetrance and severity. Here, we identify a novel SCN5A loss of function variant, p.1449Y>H, which presented with high penetrance and complete left bundle branch block, totally masking the typical findings on the electrocardiogram. We highlight the possibility of this overlap combination that makes impossible an electrocardiographic diagnosis and, through a functional analysis, associate the p.1449Y>H variant to SCN5A pathogenicity.

Keywords: Brugada syndrome; SCN5A; left bundle branch block; loss of function; patch clamp.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brugada Syndrome* / diagnosis
  • Brugada Syndrome* / genetics
  • Bundle-Branch Block / diagnosis
  • Bundle-Branch Block / genetics
  • Electrocardiography
  • Humans
  • Mutation
  • NAV1.5 Voltage-Gated Sodium Channel / genetics

Substances

  • NAV1.5 Voltage-Gated Sodium Channel
  • SCN5A protein, human