The Impact of Medical Management on Quality of Life in Brugada Syndrome PatientsRichards, Sarah (2012) The Impact of Medical Management on Quality of Life in Brugada Syndrome Patients. Master's Thesis, University of Pittsburgh. (Unpublished)
AbstractPURPOSE: Brugada syndrome is an inherited cardiac arrhythmia disorder characterized by ST segment elevation in leads V1-V3 on an electrocardiogram (ECG). The main symptoms of this condition are syncope and sudden cardiac death. Medical management for symptomatic patients is an implantable cardioverter defibrillator (ICD). Research has shown that cardiac patients who have an ICD experience a decreased quality of life. However, limited studies have been done on the impact of Brugada syndrome on patient quality of life let alone the impact of medical management in this patient population. The purpose of this study was to understand how Brugada syndrome affects quality of life and if there is any difference between those with an ICD and those without one. The public health significance of this project is to further the understanding of the impacts of medical management in a specific patient population. METHODS: Participants were recruited from a multigenerational family with Brugada syndrome where a mutation has been identified in the gene GPD1L. A questionnaire was developed to ascertain medical management decisions. Additionally, the 36-Item Short Form Health Survey (SF-36v2) was used to assess quality of life. RESULTS: A total of 17 participants agreed to enroll in the study with an age range of 36-89 years. Ten of the seventeen had the family mutation in GPD1L with seven of these ten displaying the Brugada phenotype on an ECG. Only three participants had an ICD and one participant was considering the option in the near future. The main reasons for choosing an ICD were either due to a sense of inevitability and necessity or for family benefit. There was no difference in quality of life between those with the familial mutation and those without. There was also no difference observed between asymptomatic and symptomatic individuals with the mutation. Those with an ICD had a lower MCS than those without an ICD (p-value 0.013) with no other significant differences observed. CONCLUSION: Reasons underlying ICD decision-making are similar to those seen in other studies, indicating that Brugada patients’ experiences are similar to other patient groups with an ICD. There was no statistical difference in quality of life between those with and those without a genetic diagnosis or those with and without symptoms. The difference between those with and without an ICD indicates that medical management does impact quality of life, adding more evidence to support there is a significant psychosocial aspect to Brugada syndrome management. Additional research is needed to better address the specific needs of this patient population. Share
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