At this time, genetic screening is only recommended as a diagnostic tool.28 Conclusion The amount of information about BrS has been exponentially increasing since it was first described two decades ago
despite the fact that many questions and controversies remain. In summary, patients should only be diagnosed if a type 1 pattern Inhibitors,research,lifescience,medical is present in the ECG. This is not an ECG that can be ignored, no matter the age of the patient or the context in which the ECG was obtained. Second, since the ECG is an indicator of a possible familial disease, family members should be investigated in case they might be at risk of SCD. Third, BrS-type ECG patterns that are induced by acute fever or drugs is a medical emergency, and patients should remain monitored. Finally, despite the Inhibitors,research,lifescience,medical controversy over the value of the EPS for risk stratification, the inducibility during the EPS is a clear indicator that the heart may be more excitable and that the patient may be at higher risk of SCD. At present, without any other tool available to identify the few asymptomatic patients at risk, the use of EPS can be lifesaving. Funding Statement Funding/Support: Inhibitors,research,lifescience,medical The authors have no funding disclosures. Footnotes Conflict of Interest Disclosure: All authors have completed and submitted the Methodist DeBakey Cardiovascular Journal Conflict of Interest Statement Inhibitors,research,lifescience,medical and
none were reported.
Introduction Atrial fibrillation (AF), the most common sustained cardiac arrhyth-mia, is associated with a reduced quality of life and increased risk of stroke and death.1-3 Annual U.S. health care costs associated
with treating the condition have been estimated at $6.65 billion.4 The considerable health Inhibitors,research,lifescience,medical care burden will accelerate as the prevalence of AF has been projected to nearly triple by the year 2050.5 Unfortunately, present treatment strategies suffer from limited efficacy and risks of adverse events6, 7 stemming from our limited understanding of the mechanisms of AF, a notion that is reflected by persistent disagreement regarding its underlying pathophysiology and approach to catheter ablation.8 Recognition that AF has a heritable component has led to an intensive PI3K inhibitor search for the genetic culprits responsible for the disorder. Identification of genes Vasopressin Receptor that predispose to the arrhythmia has begun to provide further insight into the factors that govern its initiation and maintenance.9 Based on the diverse genetic culprits identified thus far, it has become increasingly clear that AF is a heterogeneous disorder that will likely necessitate a personalized therapeutic approach to optimize treatment outcomes.9 AF as a Genetic Disease A variety of clinical features including advanced age, structural heart disease, and hypertension have been identified as risk factors for AF.