Long-term follow-up of primary prophylactic implantable cardioverter-defibrillator therapy in Brugada syndrome.
OBJECTIVE
To analyse the follow-up data of implantable cardioverter-defibrillator (ICD) therapy in Brugada syndrome (BS).


RESULTS
We conducted a retrospective, single centre study of 47 patients (mean age: 44.5 +/- 15 years) with BS, who underwent primary prophylactic ICD implantation. All patients had baseline spontaneous (23 patients) or drug-induced (24 patients) coved type I ECG pattern. All patients were judged to be at high risk because of syncope (26 patients) and/or a positive family history of sudden death (26 patients). During a median follow-up of 47.5 months, seven patients had appropriate shocks. The presence of spontaneous type I ECG and non-sustained ventricular tachyarrhythmia in the ICD datalog suggested a trend towards shorter appropriate shock-free survival by Kaplan-Meier analysis (P = 0.037 and P = 0.012, respectively). Seventeen patients received inappropriate shocks (IS); eight patients for sinus tachycardia; six patients for new onset atrial arrhythmias; and five patients for noise oversensing. In multivariable Cox-regression analysis, new onset atrial fibrillation (AF) and less than 50 years of age were independent predictors of significantly shorter IS-free survival (P = 0.04 and P = 0.036, respectively).


CONCLUSIONS
In high-risk patients with BS, primary prophylactic ICD therapy is an effective treatment. In this, young and otherwise healthy patient population, the IS rate is high.
Sarkozy
Andrea
A
Cardiovascular Research and Teaching Institute, OLV Hospital, Moorselbaan 164, 9300 Aalst, Belgium. andreasarkozy@yahoo.ca
Boussy
Tim
T
Kourgiannides
Georgios
G
Chierchia
Gian-Battista
GB
Richter
Sergio
S
De Potter
Tom
T
Geelen
Peter
P
Wellens
Francis
F
Spreeuwenberg
Marieke Dingena
MD
Brugada
Pedro
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents; D053840:Brugada Syndrome / Q000628:therapy*; D002648:Child; D016757:Death, Sudden, Cardiac / Q000209:etiology; D017147:Defibrillators, Implantable / Q000009:adverse effects; D004562:Electrocardiography; D004594:Electrophysiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055502:Secondary Prevention; D013610:Tachycardia / Q000209:etiology; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000209:etiology
D000889:Anti-Arrhythmia Agents