Novel SCN5A p.Val1667Asp Missense Variant Segregation and Characterization in a Family with Severe Brugada Syndrome and Multiple Sudden Deaths

Michelle M Monasky, Emanuele Micaglio, Giuseppe Ciconte, Ilaria Rivolta, Valeria Borrelli, Andrea Ghiroldi, Sara D'Imperio, Anna Binda, Dario Melgari, Sara Benedetti, Predrag Mitrovic, Luigi Anastasia, Valerio Mecarocci, Žarko Ćalović, Giorgio Casari, Carlo Pappone

Research output: Contribution to journalArticlepeer-review


Genetic testing in Brugada syndrome (BrS) is still not considered to be useful for clinical management of patients in the majority of cases, due to the current lack of understanding about the effect of specific variants. Additionally, family history of sudden death is generally not considered useful for arrhythmic risk stratification. We sought to demonstrate the usefulness of genetic testing and family history in diagnosis and risk stratification. The family history was collected for a proband who presented with a personal history of aborted cardiac arrest and in whom a novel variant in the SCN5A gene was found. Living family members underwent ajmaline testing, electrophysiological study, and genetic testing to determine genotype-phenotype segregation, if any. Patch-clamp experiments on transfected human embryonic kidney 293 cells enabled the functional characterization of the SCN5A novel variant in vitro. In this study, we provide crucial human data on the novel heterozygous variant NM_198056.2:c.5000T>A (p.Val1667Asp) in the SCN5A gene, and demonstrate its segregation with a severe form of BrS and multiple sudden deaths. Functional data revealed a loss of function of the protein affected by the variant. These results provide the first disease association with this variant and demonstrate the usefulness of genetic testing for diagnosis and risk stratification in certain patients. This study also demonstrates the usefulness of collecting the family history, which can assist in understanding the severity of the disease in certain situations and confirm the importance of the functional studies to distinguish between pathogenic mutations and harmless genetic variants.

Original languageEnglish
JournalInt J Mol Sci
Issue number9
Publication statusPublished - Apr 29 2021


  • Adolescent
  • Adult
  • Aged
  • Ajmaline/pharmacology
  • Amino Acid Substitution
  • Brugada Syndrome/complications
  • Death, Sudden, Cardiac/etiology
  • Electrocardiography
  • Female
  • Genetic Testing
  • HEK293 Cells
  • Heterozygote
  • Humans
  • Loss of Function Mutation
  • Male
  • Middle Aged
  • Mutant Proteins/genetics
  • Mutation, Missense
  • NAV1.5 Voltage-Gated Sodium Channel/genetics
  • Patch-Clamp Techniques
  • Pedigree
  • Polymorphism, Single Nucleotide
  • Recombinant Proteins/genetics


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