title: Monomorphic ventricular tachycardia in patients with Brugada syndrome: A multicenter retrospective study.
abstract: BACKGROUND
  Isolated cases of monomorphic ventricular tachycardia (MVT) in patients with Brugada syndrome (BrS) have been reported.
  
  
  OBJECTIVE
  We aimed to describe the incidence and characteristics of MVT in a cohort of patients with BrS who had received an implantable cardioverter-defibrillator (ICD).
  
  
  METHODS
  Data from 834 patients with BrS implanted with an ICD in 15 tertiary hospitals between 1993 and 2014 were included.
  
  
  RESULTS
  The mean age of enrolled patients was 45.3 ± 13.9 years; 200 patients (24%) were women. During a mean follow-up of 69.4 ± 54.3 months, 114 patients (13.7%) experienced at least 1 appropriate ICD intervention, with MVT recorded in 35 patients (4.2%) (sensitive to antitachycardia pacing in 15 [42.8%]). Only QRS width was an independent predictor of MVT in the overall population. Specifically, 6 (17.1%) patients presented with right ventricular outflow tract tachycardia (successfully ablated from the endocardium in 4 and epicardial and endocardial ablation in 1), 2 patients with MVT arising from the left ventricle (1 successfully ablated in the supra lateral mitral annulus), and 2 (5.7%) patients with bundle branch reentry ventricular tachycardia. Significant structural heart disease was ruled out by echocardiography and/or cardiac magnetic resonance imaging.
  
  
  CONCLUSIONS
  In this retrospective study, 4.2% of patients with BrS implanted with an ICD presented with MVT confirmed as arising from the right ventricular outflow tract tachycardia in 6, patients with MVT arising from the left ventricle in 2, and patients with bundle branch reentry ventricular tachycardia in 2. Endocardial and/or epicardial ablation was successful in 80% of these cases. These data imply that the occurrence of MVT should not rule out the possibility of BrS. This finding may also be relevant for ICD model selection and programming.
authors.affiliation: Methodist Hospital, Houston, Texas. Electronic address: moirmanero@gmail.com.
authors.forename: Moisés
authors.initials: M
authors.lastname: Rodríguez-Mañero
authors.affiliation: Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Sacher
authors.affiliation: Free University of Brussels (UZ Brussel) VUB, Brussel, Belgium.
authors.forename: Carlo
authors.initials: C
authors.lastname: de Asmundis
authors.affiliation: CHU de Toulouse, Toulouse, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Maury
authors.affiliation: St. Bartholomew's Hospital, London, United Kingdom.
authors.forename: Pier D
authors.initials: PD
authors.lastname: Lambiase
authors.affiliation: Cardiology Department, University Hospital of Antwerp, Antwerp, Belgium.
authors.forename: Andrea
authors.initials: A
authors.lastname: Sarkozy
authors.affiliation: CHU de Nantes, Nantes, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Probst
authors.affiliation: APHP, Hôpital Pitié-Salpêtrière, Institut de Cardiologie, Paris, France.
authors.forename: Estelle
authors.initials: E
authors.lastname: Gandjbakhch
authors.affiliation: Instituto de Cardiología y Cirugía Cardiovascular, La Habana, Cuba.
authors.forename: Jesús
authors.initials: J
authors.lastname: Castro-Hevia
authors.affiliation: Cardiology Department, University Hospital of Antwerp, Antwerp, Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: Saenen
authors.affiliation: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Kengo
authors.initials: K
authors.lastname: Fukushima Kusano
authors.affiliation: CHU de Toulouse, Toulouse, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Rollin
authors.affiliation: Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Arbelo
authors.affiliation: Methodist Hospital, Houston, Texas.
authors.forename: Miguel
authors.initials: M
authors.lastname: Valderrábano
authors.affiliation: Hospital Universitario Virgen de la Salud, Toledo, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Arias
authors.affiliation: Complejo Hospitalario Canalejo, La Coruña, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Mosquera-Pérez
authors.affiliation: St. Bartholomew's Hospital, London, United Kingdom.
authors.forename: Richard
authors.initials: R
authors.lastname: Schilling
authors.affiliation: Free University of Brussels (UZ Brussel) VUB, Brussel, Belgium.
authors.forename: Gian-Battista
authors.initials: GB
authors.lastname: Chierchia
authors.affiliation: Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: García-Bolao
authors.affiliation: Hospital Universitario Santiago de Compostela, Santiago de Compostela, La Coruña, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: García-Seara
authors.affiliation: Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Hernandez-Ojeda
authors.affiliation: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Kamakura
authors.affiliation: Hospital Universitario Santiago de Compostela, Santiago de Compostela, La Coruña, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Martínez-Sande
authors.affiliation: Hospital Universitario Santiago de Compostela, Santiago de Compostela, La Coruña, Spain.
authors.forename: José Ramón
authors.initials: JR
authors.lastname: González-Juanatey
authors.affiliation: Bordeaux University Hospital, LIRYC Institute/INSERM 1045, Bordeaux, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Haïssaguerre
authors.affiliation: Hospital Clínic Universitario de Barcelona, Institut du Thorax, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Brugada
authors.affiliation: Free University of Brussels (UZ Brussel) VUB, Brussel, Belgium.
authors.forename: Pedro
authors.initials: P
authors.lastname: Brugada
mesh_terms: D053840:Brugada Syndrome / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy
keywords: Brugada syndrome; Implantable cardioverter-defibrillator; Ventricular fibrillation; Ventricular tachycardia