Mid-term follow-up of patients with Brugada syndrome following a cardioverter defibrillator implantation: A single center experience
Background: Brugada syndrome is an arrhythmogenic disease characterized by an ECG pattern of ST-segment elevation in the right precordial leads and an increase risk of sudden cardiac death. Risk stratification for the life-threatening arrhythmic events in Brugada syndrome is not yet established. In...
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| Format: | Article |
| Language: | English |
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Elsevier
2007-01-01
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| Series: | Indian Pacing and Electrophysiology Journal |
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| Online Access: | http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1764907 |
| _version_ | 1818230080153845760 |
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| author | Jorat MV Nikoo MH Alizadeh A Emkanjoo Z Sadr-Ameli MA |
| author_facet | Jorat MV Nikoo MH Alizadeh A Emkanjoo Z Sadr-Ameli MA |
| author_sort | Jorat MV |
| collection | DOAJ |
| description | Background: Brugada syndrome is an arrhythmogenic disease characterized by an ECG pattern of ST-segment elevation in the right precordial leads and an increase risk of sudden cardiac death. Risk stratification for the life-threatening arrhythmic events in Brugada syndrome is not yet established. In the present study, we report our experience in patients with Brugada syndrome, following an ICD implantation.Methods and Results: A total of 12 patients (11 men, 1 woman) with a mean age of 46.5±11.8 were studied. At diagnosis, 7 patients had syncope of unknown origin, 2 patients were asymptomatic, 2 patients were survivors of cardiac arrest, and 1 had documented clinical VT requiring direct cardioversion for termination. Age was similar between the symptomatic and asymptomatic patients (46.6±13 vs. 46±2.8, respectively). Two patients reported a family history of sudden cardiac death. In 3 patients, spontaneous coved-type ECG was found at baseline. In 9 patients, a class I antiarrhythmic drug administration unmasked the characteristic type I ECG. In 4 patients (2 symptomatic with syncope at presentation and 2 asymptomatic), who underwent PES, sustained polymorphic VT or VF was induced. VF was induced by single extrastimuli in 2 symptomatic patients (1 from RV apex and 1 from RVOT). In 2 asymptomatic patients, VF was induced by two and triple ventricular extrastimli (1 from RV apex and 1 from RVOT). None of them experienced an event during follow-up. No significant difference was found between symptomatic and asymptomatic patients (p=NS). The mean follow-up period for the entire study population was 27.83±11.25 months. During follow-up, 2 patients (one with prior cardiac arrest and another with syncope) had VF. Both of them had a type I ECG after provocation with a class I antiarrhythmic drug. None of them had undergone programmed ventricular stimulation. Five patients (41.7 %) had inappropriate ICD interventions during follow-up. The cause of inappropriate therapy was sinus tachycardia in 2 patients, AF in 2 patients and T wave oversensing in 1 patient. Conclusions: Knowledge about Brugada syndrome is steadily progressing but there are still unanswered issues dealing with the risk stratification and the management of patients. |
| first_indexed | 2024-12-12T10:28:48Z |
| format | Article |
| id | doaj.art-b297c21271214a97860bf699bd7cc12f |
| institution | Directory Open Access Journal |
| issn | 0972-6292 |
| language | English |
| last_indexed | 2024-12-12T10:28:48Z |
| publishDate | 2007-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Pacing and Electrophysiology Journal |
| spelling | doaj.art-b297c21271214a97860bf699bd7cc12f2022-12-22T00:27:24ZengElsevierIndian Pacing and Electrophysiology Journal0972-62922007-01-01713339Mid-term follow-up of patients with Brugada syndrome following a cardioverter defibrillator implantation: A single center experienceJorat MVNikoo MHAlizadeh AEmkanjoo ZSadr-Ameli MABackground: Brugada syndrome is an arrhythmogenic disease characterized by an ECG pattern of ST-segment elevation in the right precordial leads and an increase risk of sudden cardiac death. Risk stratification for the life-threatening arrhythmic events in Brugada syndrome is not yet established. In the present study, we report our experience in patients with Brugada syndrome, following an ICD implantation.Methods and Results: A total of 12 patients (11 men, 1 woman) with a mean age of 46.5±11.8 were studied. At diagnosis, 7 patients had syncope of unknown origin, 2 patients were asymptomatic, 2 patients were survivors of cardiac arrest, and 1 had documented clinical VT requiring direct cardioversion for termination. Age was similar between the symptomatic and asymptomatic patients (46.6±13 vs. 46±2.8, respectively). Two patients reported a family history of sudden cardiac death. In 3 patients, spontaneous coved-type ECG was found at baseline. In 9 patients, a class I antiarrhythmic drug administration unmasked the characteristic type I ECG. In 4 patients (2 symptomatic with syncope at presentation and 2 asymptomatic), who underwent PES, sustained polymorphic VT or VF was induced. VF was induced by single extrastimuli in 2 symptomatic patients (1 from RV apex and 1 from RVOT). In 2 asymptomatic patients, VF was induced by two and triple ventricular extrastimli (1 from RV apex and 1 from RVOT). None of them experienced an event during follow-up. No significant difference was found between symptomatic and asymptomatic patients (p=NS). The mean follow-up period for the entire study population was 27.83±11.25 months. During follow-up, 2 patients (one with prior cardiac arrest and another with syncope) had VF. Both of them had a type I ECG after provocation with a class I antiarrhythmic drug. None of them had undergone programmed ventricular stimulation. Five patients (41.7 %) had inappropriate ICD interventions during follow-up. The cause of inappropriate therapy was sinus tachycardia in 2 patients, AF in 2 patients and T wave oversensing in 1 patient. Conclusions: Knowledge about Brugada syndrome is steadily progressing but there are still unanswered issues dealing with the risk stratification and the management of patients.http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1764907Brugada syndromeCardioverter defibrillatorProgrammed ventricular stimulation |
| spellingShingle | Jorat MV Nikoo MH Alizadeh A Emkanjoo Z Sadr-Ameli MA Mid-term follow-up of patients with Brugada syndrome following a cardioverter defibrillator implantation: A single center experience Indian Pacing and Electrophysiology Journal Brugada syndrome Cardioverter defibrillator Programmed ventricular stimulation |
| title | Mid-term follow-up of patients with Brugada syndrome following a cardioverter defibrillator implantation: A single center experience |
| title_full | Mid-term follow-up of patients with Brugada syndrome following a cardioverter defibrillator implantation: A single center experience |
| title_fullStr | Mid-term follow-up of patients with Brugada syndrome following a cardioverter defibrillator implantation: A single center experience |
| title_full_unstemmed | Mid-term follow-up of patients with Brugada syndrome following a cardioverter defibrillator implantation: A single center experience |
| title_short | Mid-term follow-up of patients with Brugada syndrome following a cardioverter defibrillator implantation: A single center experience |
| title_sort | mid term follow up of patients with brugada syndrome following a cardioverter defibrillator implantation a single center experience |
| topic | Brugada syndrome Cardioverter defibrillator Programmed ventricular stimulation |
| url | http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1764907 |
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