Long-term outcome of pulmonary vein isolation in patients with paroxysmal atrial fibrillation and Brugada syndrome.
The therapeutical management of atrial fibrillation (AF) in the setting of Brugada syndrome (BS) might be challenging as many antiarrhythmic drugs (AADs) with sodium channel blocking properties might lead to to the development of ventricular arrhythmias. This study sought to evaluate the clinical outcome in a consecutive series of patients with BS having undergone pulmonary vein (PV) isolation by means of radiofrequency (RF) or cryoballoon (CB) ablation and the efficacy of catheter ablation for preventing inappropriate interventions delivered by implantable cardioverter defibrillators (ICD) on a 3-year follow up.



Twenty-three consecutive patients with BS (13 males; mean age was 47 ± 18 years) having undergone PV isolation for drug-resistant paroxysmal AF were enrolled. Eleven patients (48%) had an ICD implanted of whom four had inappropriate shocks secondary to rapid AF. Over a mean follow-up period of 35.0 ± 25.4 months (median 36 months) the freedom from AF recurrence after the index PV isolation procedure was 74% without AADs. Patients with inappropriate ICD interventions for AF did not present futher ICD shocks after AF ablation. No major complications occurred.



Catheter ablation is a valid therapeutic choice for patients with BS and paroxysmal AF considering the high success rates, the limitations of the AADs and the safety of the procedure, and it should be taken into consideration especially in those patients presenting inappropriate ICD shocks due to rapid AF.
Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium.
Giacomo
G
Mugnai
Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium.
Burak
B
Hünük
Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium.
Erwin
E
Ströker
Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium.
Diego
D
Ruggiero
Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium.
Hugo Enrique
HE
Coutino-Moreno
Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium.
Ken
K
Takarada
Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium.
Valentina
V
De Regibus
Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium.
Rajin
R
Choudhury
Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium.
Juan Pablo
JP
Abugattas de Torres
Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium.
Darragh
D
Moran
Electrophysiology Unit, Maria Cecilia Hospital, via Corriera 1, 48033 Cotignola (RA), Italy.
Saverio
S
Iacopino
Electrophysiology Unit, Maria Cecilia Hospital, via Corriera 1, 48033 Cotignola (RA), Italy.
Pasquale
P
Filannino
Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium.
Giulio
G
Conte
Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium.
Juan
J
Sieira
Department of Anaesthesiology, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium.
Jan
J
Poelaert
Department of Anaesthesiology, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium.
Stefan
S
Beckers
Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium.
Pedro
P
Brugada
Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium.
Carlo
C
de Asmundis
Heart Rhythm Management Center, UZ Brussel-VUB Laarbeklaan 101, 1090 Brussels, Belgium.
Gian-Battista
GB
Chierchia
D000200:Action Potentials; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000469:parasitology / Q000601:surgery*; D053840:Brugada Syndrome / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D017115:Catheter Ablation / Q000009:adverse effects; D003452:Cryosurgery / Q000009:adverse effects; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000295:instrumentation; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome