title: Benefit of implantable cardioverter-defibrillator therapy after generator replacement in patients with Brugada syndrome.
abstract: BACKGROUND
  An implantable cardioverter-defibrillator (ICD) is the only proven effective therapeutic strategy for patients with Brugada syndrome (BS). However, it is controversial whether the device should be replaced even in patients who had never experienced appropriate ICD therapy until the time of generator replacement.
  
  
  RESULTS
  This was a nationwide, multicenter retrospective study that enrolled patients who were diagnosed with BS and had an ICD implantation between January 1998 and April 2014. Appropriate ICD therapies administered for ventricular tachyarrhythmia were evaluated during follow-up. A total of 117 patients (age 43 ± 12 years, male 115 [98.3%]) were enrolled, and the mean follow-up duration was 6.0 ± 4.1 years. Thirty-seven (31.6%) patients had experienced appropriate ICD therapy during follow-up. Of all patients, 46 underwent replacement of the device. After the first generator replacement, the incidence of appropriate ICD therapy remained as high as 65.2% in patients who previously experienced appropriate ICD therapy before generator replacement. In 30 patients who did not experience any cardiac events until the first generator change, two (8.7%) had an episode of appropriate ICD therapy afterwards.
  
  
  CONCLUSIONS
  No episode of ICD therapy before generator replacement could not guarantee a safe clinical course. ICD generator replacement should be considered even in patients without ICD therapy before.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea.
authors.forename: Ju Youn
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea.
authors.forename: Sung-Hwan
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Heart Research Center, Chonnam National University Hospital, Chonnam National University.
authors.forename: Sung Su
authors.initials: SS
authors.lastname: Kim
authors.affiliation: Heart Research Center, Chonnam National University Hospital, Chonnam National University.
authors.forename: Ki Hong
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Heart Research Center, Chonnam National University Hospital, Chonnam National University.
authors.forename: Hyung-Wook
authors.initials: HW
authors.lastname: Park
authors.affiliation: Heart Research Center, Chonnam National University Hospital, Chonnam National University.
authors.forename: Jeong-Gwan
authors.initials: JG
authors.lastname: Cho
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine.
authors.forename: Jae-Sun
authors.initials: JS
authors.lastname: Uhm
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine.
authors.forename: Boyoung
authors.initials: B
authors.lastname: Joung
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine.
authors.forename: Hui-Nam
authors.initials: HN
authors.lastname: Pak
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine.
authors.forename: Moon-Hyoung
authors.initials: MH
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine.
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine.
authors.forename: Young Keun
authors.initials: YK
authors.lastname: On
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine.
authors.forename: June Soo
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital.
authors.forename: Hong Euy
authors.initials: HE
authors.lastname: Lim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital.
authors.forename: Jaemin
authors.initials: J
authors.lastname: Shim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital.
authors.forename: Jong-Il
authors.initials: JI
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital.
authors.forename: Sang Weon
authors.initials: SW
authors.lastname: Park
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital.
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine.
authors.forename: Woo Seok
authors.initials: WS
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine.
authors.forename: Jun
authors.initials: J
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine.
authors.forename: Gi-Byoung
authors.initials: GB
authors.lastname: Nam
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine.
authors.forename: Kee-Joon
authors.initials: KJ
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine.
authors.forename: You-Ho
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea. Electronic address: oys@catholic.ac.kr.
authors.forename: Yong-Seog
authors.initials: YS
authors.lastname: Oh
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea. Electronic address: myleecardio@catholic.ac.kr.
authors.forename: Man-Young
authors.initials: MY
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea.
authors.forename: Tai-Ho
authors.initials: TH
authors.lastname: Rho
mesh_terms: D000328:Adult; D053840:Brugada Syndrome / Q000628:therapy*; D017147:Defibrillators, Implantable; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Brugada syndrome; Implantable cardioverter-defibrillator; Replacement