title: Surface Electrocardiogram Screening for Subcutaneous Implantable Cardioverter-Defibrillators in Japanese Patients With and Without Brugada Syndrome.
abstract: Subcutaneous implantable cardioverter-defibrillators (S-ICD) could eliminate lead-associated complications. We assessed the prevalence of S-ICD ineligibility in conventional ICD recipients and compared it in patients with and without Brugada syndrome (BrS).
  
  
  
  Consecutive patients with a transvenous ICD without an indication for antibradycardia pacing were assessed. A patient was considered eligible for S-ICD if the ECG satisfied the screening template, both supine and standing, in ≥1 lead. Among 130 patients (103 men, age 57±15 years), a total of 18 (13.8%) patients were ineligible. The BrS group (n=33) had a significantly higher prevalence of S-ICD screening failure as compared with the non-BrS group (P=0.003; 30% vs. 8.2%). In the BrS group, the body mass index (BMI) was significantly lower, and T/QRS amplitude in lead I was significantly higher in those who were ineligible than that in the patients who were eligible. Of the 10 BrS patients failing the screening, 4 became eligible in the right parasternal electrode position.
  
  
  
  Among current ICD patients, there was a high incidence of patients with BrS who were unsuitable for S-ICD based on the left parasternal screening test. Suitability screening of patients for S-ICDs should be conducted carefully in patients with BrS, particularly if the BMI is low. Right parasternal electrode positioning should also be tested in such BrS patients.
authors.affiliation: Heart Rhythm Center, Tokyo Medical and Dental University.
authors.forename: Mihoko
authors.initials: M
authors.lastname: Kawabata
authors.affiliation: Heart Rhythm Center, Tokyo Medical and Dental University.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Goya
authors.affiliation: Heart Rhythm Center, Tokyo Medical and Dental University.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sasaki
authors.affiliation: Heart Rhythm Center, Tokyo Medical and Dental University.
authors.forename: Shingo
authors.initials: S
authors.lastname: Maeda
authors.affiliation: Heart Rhythm Center, Tokyo Medical and Dental University.
authors.forename: Atsuhiko
authors.initials: A
authors.lastname: Yagishita
authors.affiliation: Heart Rhythm Center, Tokyo Medical and Dental University.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shirai
authors.affiliation: Heart Rhythm Center, Tokyo Medical and Dental University.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Kaneko
authors.affiliation: Heart Rhythm Center, Tokyo Medical and Dental University.
authors.forename: Shinya
authors.initials: S
authors.lastname: Shiohira
authors.affiliation: Department of Cardiovascular Medicine, Tokyo Medical and Dental University.
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Isobe
authors.affiliation: Heart Rhythm Center, Tokyo Medical and Dental University.
authors.forename: Kenzo
authors.initials: K
authors.lastname: Hirao
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D015992:Body Mass Index; D053840:Brugada Syndrome / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D017147:Defibrillators, Implantable; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D015995:Prevalence
keywords: Body mass index; Brugada syndrome; Subcutaneous implantable cardioverter-defibrillator; Surface ECG screening