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Implantable cardioverter-defibrillator in Brugada syndrome: Long-term follow-up

Ibrahim El-Battrawy1,2, Gretje Roterberg1, Volker Liebe1

  • 1First Department of Medicine, Faculty of Medicine, University Medical Centre Mannheim (UMM), University of Heidelberg, Mannheim, Germany.

Clinical Cardiology
|August 24, 2019
PubMed

Insights

Implantable cardioverter-defibrillators (ICDs) are used for Brugada syndrome (BrS) patients at risk of sudden cardiac death. However, ICDs carry risks of complications, including inappropriate shocks, particularly in symptomatic BrS patients.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Brugada syndrome (BrS) is a genetic disorder associated with an increased risk of sudden cardiac death (SCD).
  • Implantable cardioverter-defibrillators (ICDs) are a recommended treatment for BrS patients to prevent SCD.
  • Long-term outcomes and complication data for ICDs in BrS patients remain a subject of debate.

Purpose of the Study:

  • To systematically review and analyze the outcomes and complications of ICD implantation in patients diagnosed with Brugada syndrome.
  • To evaluate the incidence of appropriate and inappropriate shocks, as well as device-related complications in a large cohort of BrS patients.

Main Methods:

  • A systematic literature review was conducted using major databases: PubMed, Web of Science, Cochrane Library, and Cinahl.
  • Data from 11 studies, encompassing 747 BrS patients who received ICDs, were assimilated and analyzed.

Main Results:

  • The study analyzed 747 Brugada syndrome patients (mean age 43.1 years, 82.5% male) receiving ICDs.
  • Appropriate shocks occurred in 18.1% of patients over an average follow-up of 82.3 months. Device complications included lead failure (5.4%) and infection (3.9%).
  • Inappropriate shocks were also documented in 18.1% of patients, with management strategies including pulmonary vein isolation and drug therapy.

Conclusions:

  • ICD therapy in Brugada syndrome patients is associated with significant device-related complications.
  • A substantial risk of inappropriate shocks was observed, particularly in symptomatic BrS patients.
  • The findings highlight the need for careful patient selection and monitoring in BrS patients with ICDs.
Abstract

Keywords:
Brugadacomplicationsdevicesoutcome

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