Outcomes in Brugada Syndrome Patients With Implantable Cardioverter-Defibrillators: Insights From the SGLT2 Registry
Background and ObjectivesBrugada syndrome (BrS) is a cardiac ion channelopathy with characteristic electrocardiographic patterns, predisposing affected individuals to sudden cardiac death (SCD). Implantable cardioverter-defibrillator (ICD) is used for primary or secondary prevention in BrS, but its...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-03-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fphys.2020.00204/full |
| _version_ | 1819278197647212544 |
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| author | Sharen Lee Ka Hou Christien Li Ka Hou Christien Li Jiandong Zhou Keith Sai Kit Leung Rachel Wing Chuen Lai Guoliang Li Tong Liu Konstantinos P. Letsas Ngai Shing Mok Qingpeng Zhang Gary Tse Gary Tse Gary Tse |
| author_facet | Sharen Lee Ka Hou Christien Li Ka Hou Christien Li Jiandong Zhou Keith Sai Kit Leung Rachel Wing Chuen Lai Guoliang Li Tong Liu Konstantinos P. Letsas Ngai Shing Mok Qingpeng Zhang Gary Tse Gary Tse Gary Tse |
| author_sort | Sharen Lee |
| collection | DOAJ |
| description | Background and ObjectivesBrugada syndrome (BrS) is a cardiac ion channelopathy with characteristic electrocardiographic patterns, predisposing affected individuals to sudden cardiac death (SCD). Implantable cardioverter-defibrillator (ICD) is used for primary or secondary prevention in BrS, but its use remains controversial amongst low-risk asymptomatic patients. The present study aims to examine indicators for ICD implantation amongst BrS patients with different disease manifestations.MethodsThis study included BrS patients who received ICDs between 1997 and 2018. The cohort was divided into three categories based on presentations before ICD implantation: asymptomatic, syncope, ventricular tachycardia/ventricular fibrillation (VT/VF). Univariate and multivariate Cox-regression analysis were performed to identify independent predictors of appropriate and inappropriate shock delivery.ResultsA total of 136 consecutive patients were included with a median follow-up of 95 (IQR: 80) months. Appropriate shocks were delivered in 34 patients (25.0%) whereas inappropriate shocks were delivered in 24 patients (17.6%). Complications occurred in 30 patients (22.1%). Type 1 Brugada pattern were found to be an independent predictor of appropriate shock delivery, whilst the presence of other arrhythmia was predictive for both appropriate and inappropriate ICD shock delivery under multivariate Cox regression analysis.ConclusionICD therapy is effective for primary and secondary prevention of SCD in BrS. Whilst appropriate shocks occur more frequently in BrS patients presenting with VT/VF, they also occur in asymptomatic patients. Further research in risk stratification can improve patient prognosis while avoid unnecessary ICD implantation. |
| first_indexed | 2024-12-24T00:08:11Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-12-24T00:08:11Z |
| publishDate | 2020-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj.art-777aeba50c17488b91a4bb2047323ef32022-12-21T17:24:58ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2020-03-011110.3389/fphys.2020.00204519161Outcomes in Brugada Syndrome Patients With Implantable Cardioverter-Defibrillators: Insights From the SGLT2 RegistrySharen Lee0Ka Hou Christien Li1Ka Hou Christien Li2Jiandong Zhou3Keith Sai Kit Leung4Rachel Wing Chuen Lai5Guoliang Li6Tong Liu7Konstantinos P. Letsas8Ngai Shing Mok9Qingpeng Zhang10Gary Tse11Gary Tse12Gary Tse13Laboratory of Cardiovascular Physiology, Li Ka Shing Institute of Health Sciences, Hong Kong, ChinaLaboratory of Cardiovascular Physiology, Li Ka Shing Institute of Health Sciences, Hong Kong, ChinaFaculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United KingdomSchool of Data Science, City University of Hong Kong, Hong Kong, ChinaLaboratory of Cardiovascular Physiology, Li Ka Shing Institute of Health Sciences, Hong Kong, ChinaLaboratory of Cardiovascular Physiology, Li Ka Shing Institute of Health Sciences, Hong Kong, ChinaDepartment of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, ChinaTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, ChinaLaboratory of Cardiac Electrophysiology, Second Department of Cardiology, Evangelismos General Hospital of Athens, Athens, GreeceDepartment of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, ChinaSchool of Data Science, City University of Hong Kong, Hong Kong, ChinaTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, ChinaDepartment of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, ChinaXiamen Cardiovascular Hospital, Xiamen University, Xiamen, ChinaBackground and ObjectivesBrugada syndrome (BrS) is a cardiac ion channelopathy with characteristic electrocardiographic patterns, predisposing affected individuals to sudden cardiac death (SCD). Implantable cardioverter-defibrillator (ICD) is used for primary or secondary prevention in BrS, but its use remains controversial amongst low-risk asymptomatic patients. The present study aims to examine indicators for ICD implantation amongst BrS patients with different disease manifestations.MethodsThis study included BrS patients who received ICDs between 1997 and 2018. The cohort was divided into three categories based on presentations before ICD implantation: asymptomatic, syncope, ventricular tachycardia/ventricular fibrillation (VT/VF). Univariate and multivariate Cox-regression analysis were performed to identify independent predictors of appropriate and inappropriate shock delivery.ResultsA total of 136 consecutive patients were included with a median follow-up of 95 (IQR: 80) months. Appropriate shocks were delivered in 34 patients (25.0%) whereas inappropriate shocks were delivered in 24 patients (17.6%). Complications occurred in 30 patients (22.1%). Type 1 Brugada pattern were found to be an independent predictor of appropriate shock delivery, whilst the presence of other arrhythmia was predictive for both appropriate and inappropriate ICD shock delivery under multivariate Cox regression analysis.ConclusionICD therapy is effective for primary and secondary prevention of SCD in BrS. Whilst appropriate shocks occur more frequently in BrS patients presenting with VT/VF, they also occur in asymptomatic patients. Further research in risk stratification can improve patient prognosis while avoid unnecessary ICD implantation.https://www.frontiersin.org/article/10.3389/fphys.2020.00204/fullBrugada syndromeICD (implantable cardioverter-defibrillator)sudden cardiac deathventricular tachiarrhythmiasrisk stratificacion |
| spellingShingle | Sharen Lee Ka Hou Christien Li Ka Hou Christien Li Jiandong Zhou Keith Sai Kit Leung Rachel Wing Chuen Lai Guoliang Li Tong Liu Konstantinos P. Letsas Ngai Shing Mok Qingpeng Zhang Gary Tse Gary Tse Gary Tse Outcomes in Brugada Syndrome Patients With Implantable Cardioverter-Defibrillators: Insights From the SGLT2 Registry Frontiers in Physiology Brugada syndrome ICD (implantable cardioverter-defibrillator) sudden cardiac death ventricular tachiarrhythmias risk stratificacion |
| title | Outcomes in Brugada Syndrome Patients With Implantable Cardioverter-Defibrillators: Insights From the SGLT2 Registry |
| title_full | Outcomes in Brugada Syndrome Patients With Implantable Cardioverter-Defibrillators: Insights From the SGLT2 Registry |
| title_fullStr | Outcomes in Brugada Syndrome Patients With Implantable Cardioverter-Defibrillators: Insights From the SGLT2 Registry |
| title_full_unstemmed | Outcomes in Brugada Syndrome Patients With Implantable Cardioverter-Defibrillators: Insights From the SGLT2 Registry |
| title_short | Outcomes in Brugada Syndrome Patients With Implantable Cardioverter-Defibrillators: Insights From the SGLT2 Registry |
| title_sort | outcomes in brugada syndrome patients with implantable cardioverter defibrillators insights from the sglt2 registry |
| topic | Brugada syndrome ICD (implantable cardioverter-defibrillator) sudden cardiac death ventricular tachiarrhythmias risk stratificacion |
| url | https://www.frontiersin.org/article/10.3389/fphys.2020.00204/full |
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