Incidence of atrial tachyarrhythmias in patients with early repolarization syndrome and Brugada syndrome: analysis of patients with implantable cardioverter defibrillators

Abstract

Purpose: The electrocardiographic early repolarization syndrome (ERS) is associated with a risk of sudden cardiac death (SCD). It has not been known whether the arrhythmogenic substrate in patients with ERS is restricted to the ventricular level. The aim of this retrospective study was to evaluate the incidence of inappropriate shocks (IS) due to atrial tachyarrhythmias (ATAs) in patients with ERS as compared with Brugada syndrome (BrS). Methods: We analyzed data from 47 consecutive patients diagnosed with ERS and BrS who underwent implantable cardioverter defibrillator (ICD) implantation from May 1998 to December 2011. Three in patients with BrS had paroxysmal atrial fibrillation (AF). The clinical data were collected and analyzed for all events with shocks. Results: Seventeen patients with ERS (age 38.6±11.1, male=14) and 30 patients with BrS (43.6±11.3, male = 29) were enrolled. Twelve patients experienced AF after defibrillation for ventricular arrhythmia (6 in ERS vs. 6 in BrS, P = NS). During a mean follow-up of 5.3±4.5 years in the ERS and 4.4±4.0 years in the BrS, five patients received appropriate shock (3 in ERS vs. 2 in BrS, P = 0.25). There was no significant difference in the prevalence of ATAs in patients who diagnosed ERS compared with patients in BrS from pre- to post- ICD implantation (9 in ERS vs. 12 in BrS, P = 0.54). Three of 17 (17.6%) ERS and 6 of 30 (20.0%) BrS patients received IS due to ATAs during this periods (Figure, P = 0.72). ![Figure][1] Figure 1 Conclusions: ATA occurred not infrequently in patients with ERS and ICD implantation. There were no differences in the occurrence of ATA and IS in patients with ERS as compared to patients with BrS. [1]: pending:yes