Clinical Research
Efficacy and safety of implantable cardioverter defibrillator in patients with Brugada syndrome
Lirong Yan, Yan Dai, Keping Chen, Yuqiu Li, Chao Li, Ying Wu, Ruohan Chen, Qi Sun, Wei Hua, Shu Zhang
Published 2019-02-28
Cite as Chin J Cardiac Arrhyth, 2019, 23(1): 18-23. DOI: 10.3760/cma.j.issn.1007-6638.2019.01.005
Abstract
ObjectiveTo analyse the efficacy and safety of implantable cardioverter defibrillator (ICD) in patients with Brugada syndrome.
MethodsWe retrospectively studied Brugada syndrome patients who had ICD implanted in Fuwai Hospital from January 2009 to December 2017. Outcome data, including appropriate ICD therapy, inappropriate therapy and the complications associated with ICD implantation were obtained.
ResultsTwenty consecutive patients were included in this study. The proportion of males (n=18, 90.0%) is higher than females (n=2, 10.0%) , and the average ICD implanted age was (47.6±8.6) years. Seven patients (35.0%) had family history of sudden cardiac death (SCD) . Nine patients (45.0%) presented with unexplained syncope, 5 patients presented with aborted cardiac arrest, and 1 patient presented with polymorphic ventricular tachycardia (PMVT) . Five patients (25.0%) were asymptomatic before device implantation. Over a mean follow-up period of (51.4 ± 40.4) months, ICD provided appropriate therapy to 7 patients (35.0%) , the appropriate ICD therapy rate was 9.9%/year. Although there was no significant difference, the rates of appropriate therapy for symptomatic patients was higher than for asymptomatic patients (40.0% vs. 20.0%, P=0.613) . Inappropriate therapy occurred in 7 patients (35.0%) , and the inappropriate ICD therapy rate was 7.7%/year. Two patients (10.0%) experienced complications associated with ICD implantation. There was no death case during the follow-up.
ConclusionThe rate of appropriate ICD therapy in Brugada syndrome is high, especially in symptomatic patients, but also occurred in asymptomatic patients. The frequency of inappropriate ICD therapy is high. However, most of which could be reduced by careful device programming.
Key words:
Defibrillators, implantable; Brugada syndrome; Sudden cardiac death
Contributor Information
Lirong Yan
Center of Arrhythmia, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
Yan Dai
Keping Chen
Yuqiu Li
Chao Li
Ying Wu
Ruohan Chen
Qi Sun
Wei Hua
Shu Zhang