• J. Cardiovasc. Electrophysiol. · Oct 2011

    Long-term follow-up in patients with presumptive Brugada syndrome treated with implanted defibrillators.

    • Daniel Steven, Kurt C Roberts-Thomson, Keiichi Inada, Jens Seiler, Bruce A Koplan, Usha B Tedrow, Michel O Sweeney, Laurence E Epstein, and William G Stevenson.
    • Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. dsteven@uke.de
    • J. Cardiovasc. Electrophysiol. 2011 Oct 1; 22 (10): 1115-9.

    IntroductionRisk stratification for patients with suspected Brugada syndrome (BS) remains difficult. Implantation of cardioverter-defibrillators (ICDs) in high-risk patients provides continuous long-term arrhythmia protection.MethodsData of 33 consecutive patients undergoing ICD implantation after BS evaluation between 1995 and 2008 were reviewed.ResultsThere were 30 (91%) men and 3 (9%) women (46.4 ± 11.7 years). Type I Brugada was noted in 18 (54.5%), type II in 12 (36.4%) patients, and ST elevation after drug challenge in 3 patients (9.1%). Three patients had prior cardiac arrest; 70% a history of syncope; and 56% ventricular arrhythmias at the electrophysiology study. During 7.9 ± 3.6 years of follow-up, 2 patients with prior arrest received appropriate ICD shocks. None of the 30 patients without prior arrest had a sustained arrhythmia detected. ICD-related adverse effects occurred in 11 (33%) patients, including inappropriate shocks in 5 (15%). Eight patients (24%) developed 11 major device-related complications including subclavian vein thrombosis (1), pericardial effusion (1), lead fracture (2), and infection (2); in 4 patients the only complication was premature battery depletion that required early ICD replacement; however, some of these complications such as lead fractures and early battery depletion may not be specific for this patient cohort and may not repeat in the future.ConclusionRisk stratification for patients with BS for primary prevention remains challenging. The low risk of arrhythmic events that is exceeded by ICD-related adverse effects should inform discussions with patients who do not have a prior history of cardiac arrest.© 2011 Wiley Periodicals, Inc.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…