title: Long-term efficacy of catheter ablation for paroxysmal atrial fibrillation in patients with Brugada syndrome and an implantable cardioverter-defibrillator to prevent inappropriate shock therapy.
abstract: In patients with an implantable cardioverter-defibrillator (ICD) and Brugada syndrome (BrS), the long-term efficacy of catheter ablation for preventing inappropriate shock therapy due to paroxysmal atrial fibrillation (PAF) has not been elucidated.
  
  
  
  To evaluate the efficacy of atrial fibrillation (AF) ablation for PAF for prevention of inappropriate ICD therapy over a longer follow-up period.
  
  
  
  We enrolled 76 men with BrS and an ICD, with a mean age of 46.2 ± 16.5 years. Twenty-one patients had AF (19 had PAF, 1 had persistent AF, and 1 had longstanding persistent AF). Fourteen patients with PAF underwent pulmonary vein isolation (PVI) and received follow-up electrophysiological study (EPS) 6 months after the first PVI. If necessary, ablation was performed.
  
  
  
  Over a mean follow-up period of 3.3 ± 1.4 years after the repeat session, 13 of the 14 patients (92.9%) had no recurrence of AF. Six patients with PAF without inappropriate ICD therapy before PVI had no recurrence of AF and no inappropriate therapy during follow-up. Among the 8 patients who had inappropriate therapy because of PAF before PVI, 1 patient who had recurrent AF underwent another ablation session. After this final session, there were no recurrences of AF and no inappropriate therapy (mean follow-up period 3.1± 1.2 years).
  
  
  
  Catheter ablation is effective in patients with BrS and an ICD, and prevents inappropriate ICD therapy owing to PAF; thus, catheter ablation is an appropriate first-line therapy for PAF among such patients.
authors.affiliation: Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan. Electronic address: take1124@hotmail.co.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kitamura
authors.affiliation: Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Fukamizu
authors.affiliation: Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.
authors.forename: Iwanari
authors.initials: I
authors.lastname: Kawamura
authors.affiliation: Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.
authors.forename: Rintaro
authors.initials: R
authors.lastname: Hojo
authors.affiliation: Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.
authors.forename: Yuya
authors.initials: Y
authors.lastname: Aoyama
authors.affiliation: Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.
authors.forename: Kota
authors.initials: K
authors.lastname: Komiyama
authors.affiliation: Department of Cardiology, Yokohama Minami Kyosai Hospital, Yokohama, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Nishizaki
authors.affiliation: Tokyo Medical and Dental University, Tokyo, Japan; Toride Kitasoma Medical Center Hospital, Ibaraki, Japan.
authors.forename: Masayasu
authors.initials: M
authors.lastname: Hiraoka
authors.affiliation: Tokyo Metropolitan Health and Medical Treatment Corporation Ohkubo Hospital, Tokyo, Japan.
authors.forename: Harumizu
authors.initials: H
authors.lastname: Sakurada
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D053840:Brugada Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D000069451:Long Term Adverse Effects / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000601:surgery; D016896:Treatment Outcome
keywords: Brugada syndrome; Catheter ablation; Implantable cardioverter-defibrillator; Paroxysmal atrial fibrillation; Pulmonary vein isolation; Ventricular fibrillation