Outcome after implantation of a cardioverter-defibrillator in patients with Brugada syndrome: a multicenter study.

Abstract : BACKGROUND: Brugada syndrome is an arrhythmogenic disease characterized by an increased risk of sudden cardiac death (SCD) by ventricular fibrillation. At present, an implantable cardioverter-defibrillator (ICD) is the recommended therapy in high-risk patients. This multicenter study reports the outcome of a large series of patients implanted with an ICD for Brugada syndrome. METHODS AND RESULTS: All patients (n=220, 46+/-12 years, 183 male) with a type 1 Brugada ECG pattern implanted with an ICD in 14 centers between 1993 and 2005 were investigated. ICD indication was based on resuscitated SCD (18 patients, 8%), syncope (88 patients, 40%), or positive electrophysiological study in asymptomatic patients (99 patients, 45%). The remaining 15 patients received an ICD because of a family history of SCD or nonsustained ventricular arrhythmia. During a mean follow-up of 38+/-27 months, no patient died and 18 patients (8%) had appropriate device therapy (10+/-15 shocks/patient, 26+/-33 months after implantation). The complication rate was 28%, including inappropriate shocks, which occurred in 45 patients (20%, 4+/-3 shocks/patient, 21+/-20 months after implantation). The reasons for inappropriate therapy were lead failure (19 patients), T-wave oversensing (10 patients), sinus tachycardia (10 patients), and supraventricular tachycardia (9 patients). Among implantation parameters, high defibrillation threshold, high pacing threshold, and low R-wave amplitude occurred, respectively, in 12%, 27%, and 15% of cases. CONCLUSIONS: In this large Brugada syndrome population, a low incidence of arrhythmic events was found, with an annual event rate of 2.6% during a follow-up of >3 years, in addition to a significant risk of device-related complications (8.9%/year). Inappropriate shocks were 2.5 times more frequent than appropriate ones.
Type de document :
Article dans une revue
Circulation, American Heart Association, 2006, 114 (22), pp.2317-24. 〈10.1161/CIRCULATIONAHA.106.628537〉
Liste complète des métadonnées

http://hal.univ-brest.fr/hal-00750430
Contributeur : François Guerrero <>
Soumis le : vendredi 9 novembre 2012 - 23:00:00
Dernière modification le : jeudi 13 septembre 2018 - 15:17:13

Lien texte intégral

Identifiants

Citation

Frédéric Sacher, Vincent Probst, Yoshito Iesaka, Peggy Jacon, Julien Laborderie, et al.. Outcome after implantation of a cardioverter-defibrillator in patients with Brugada syndrome: a multicenter study.. Circulation, American Heart Association, 2006, 114 (22), pp.2317-24. 〈10.1161/CIRCULATIONAHA.106.628537〉. 〈hal-00750430〉

Partager

Métriques

Consultations de la notice

800