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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
16:40

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation

Published on: February 28, 2012

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

Daniel Steven1, Kurt C Roberts-Thomson, Keiichi Inada

  • 1Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. dsteven@uke.de

Journal of Cardiovascular Electrophysiology
|May 7, 2011
PubMed

Insights

Risk stratification for Brugada syndrome (BS) is challenging. For patients without prior cardiac arrest, adverse effects from implantable cardioverter-defibrillators (ICDs) may outweigh the benefits of arrhythmia protection.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Brugada syndrome (BS) risk stratification is difficult.
  • Implantable cardioverter-defibrillators (ICDs) offer arrhythmia protection for high-risk patients.

Purpose of the Study:

  • To evaluate the outcomes and complications of ICD implantation in patients with suspected Brugada syndrome.

Main Methods:

  • Retrospective review of 33 patients with suspected Brugada syndrome who underwent ICD implantation between 1995 and 2008.
  • Analysis of patient demographics, BS type, electrophysiology study findings, and long-term follow-up data.

Main Results:

  • The study included 30 men and 3 women, with Type I Brugada observed in 54.5% of patients.
  • During a mean follow-up of 7.9 years, only 2 patients with prior cardiac arrest received appropriate ICD shocks.
  • Adverse effects occurred in 33% of patients, including inappropriate shocks (15%) and major device-related complications (24%).

Conclusions:

  • Risk stratification for primary prevention in Brugada syndrome remains challenging.
  • The low incidence of arrhythmic events in patients without prior cardiac arrest suggests that ICD-related adverse effects may exceed the benefits.
  • Discussions regarding ICD implantation should carefully consider the risk-benefit profile for patients without a history of cardiac arrest.
Abstract

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