Efficacy and safety of implantable cardioverter defibrillator in patients with Brugada syndrome

Abstract

Objective To analyse the efficacy and safety of implantable cardioverter defibrillator (ICD) in patients with Brugada syndrome. Methods We retrospectively studied Brugada syndrome patients who had ICD implanted in Fuwai Hospital from January 2009 to December 2017. Outcome data, including appropriate ICD therapy, inappropriate therapy and the complications associated with ICD implantation were obtained. Results Twenty consecutive patients were included in this study. The proportion of males (n=18, 90.0%) is higher than females (n=2, 10.0%) , and the average ICD implanted age was (47.6±8.6) years. Seven patients (35.0%) had family history of sudden cardiac death (SCD) . Nine patients (45.0%) presented with unexplained syncope, 5 patients presented with aborted cardiac arrest, and 1 patient presented with polymorphic ventricular tachycardia (PMVT) . Five patients (25.0%) were asymptomatic before device implantation. Over a mean follow-up period of (51.4 ± 40.4) months, ICD provided appropriate therapy to 7 patients (35.0%) , the appropriate ICD therapy rate was 9.9%/year. Although there was no significant difference, the rates of appropriate therapy for symptomatic patients was higher than for asymptomatic patients (40.0% vs. 20.0%, P=0.613) . Inappropriate therapy occurred in 7 patients (35.0%) , and the inappropriate ICD therapy rate was 7.7%/year. Two patients (10.0%) experienced complications associated with ICD implantation. There was no death case during the follow-up. Conclusion The rate of appropriate ICD therapy in Brugada syndrome is high, especially in symptomatic patients, but also occurred in asymptomatic patients. The frequency of inappropriate ICD therapy is high. However, most of which could be reduced by careful device programming. Key words: Defibrillators, implantable; Brugada syndrome; Sudden cardiac death