Abstract
BackgroundBrugada syndrome (BrS) is associated with sudden cardiac death (SCD). Although implantable cardioverter‐defibrillator (ICD) implantation is recommended, the long‐term outcomes and follow‐up data with regard to ICD complications have led to controversy.HypothesisIn the present study, we described the data assimilated in a total of 11 studies, analyzing the outcome in 747 BrS patients receiving ICD.MethodsData were performed and analyzed after a systematic review of literature compiled from a thorough database search (PubMed, Web of Science, Cochrane Library, and Cinahl).ResultsThe mean age of patients receiving ICD was (43.1 ± 13.4, 82.5% males, 46.6% spontaneous BrS type I). Around 15.3% of the patients were admitted due to SCD and 10.4% suffered from atrial arrhythmia. Appropriate shocks were documented in 18.1% of the patients over a mean follow‐up period of 82.3 months (47.5‐110.4). The following complications were recorded: lead failure and fracture (5.4%), lead perforation (0.7%), lead dislodgement (1.7%), infection (3.9%), pain (0.4%), subclavian vein thrombosis (0.3%), pericardial effusion (0.1%), endocarditis (0.1%), psychiatric problems (1.5%), pneumothorax (0.7%). Inappropriate shocks were documented in 18.1% of the patients. The management of inappropriate shocks was achieved by pulmonary vein isolation (0.5%), drug treatment with sotalol (1.3%) or sotalol with beta‐blocker (0.3%) and hydroquinidine (0.1%).ConclusionsICD therapy in BrS is associated with relevant ICD‐related complications including a substantial risk of inappropriate shocks more frequently in symptomatic BrS patients.
Highlights
Type I Brugada syndrome (BrS) is presented by a right bundle branch block (RBBB) and coved ST-segment elevation in precordial leads (V1-V3), and its clinical relevance lies in the fact that patients have a pronounced risk to develop malignant tachyarrhythmias.[1,2]
Due to the high risk of sudden cardiac death (SCD), it has been recommended that BrS-patients with a previous episode of sudden cardiac arrest, or those showing inducibility of a sustained ventricular arrhythmia during an electrophysiological study be treated with an implantable cardioverter-defibrillator (ICD).[4]
ICD therapy is suggested in survivors of SCD,[6] data have suggested that its use may be associated with significant
Summary
Type I Brugada syndrome (BrS) is presented by a right bundle branch block (RBBB) and coved ST-segment elevation in precordial leads (V1-V3), and its clinical relevance lies in the fact that patients have a pronounced risk to develop malignant tachyarrhythmias.[1,2] The prevalence of BrS is estimated to be 5/10 000 inhabitants with a higher prevalence in Japan and Philippines as compared to western countries. Due to the high risk of sudden cardiac death (SCD), it has been recommended that BrS-patients with a previous episode of sudden cardiac arrest, or those showing inducibility of a sustained ventricular arrhythmia during an electrophysiological study be treated with an implantable cardioverter-defibrillator (ICD).[4]. Implantable cardioverter-defibrillator (ICD) implantation is recommended, the long-term outcomes and follow-up data with regard to ICD complications have led to controversy. Hypothesis: In the present study, we described the data assimilated in a total of 11 studies, analyzing the outcome in 747 BrS patients receiving ICD. Conclusions: ICD therapy in BrS is associated with relevant ICD-related complications including a substantial risk of inappropriate shocks more frequently in symptomatic BrS patients
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