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. 2019 May 1;21(5):796-802.
doi: 10.1093/europace/euy301.

Time-to-first appropriate shock in patients implanted prophylactically with an implantable cardioverter-defibrillator: data from the Survey on Arrhythmic Events in BRUgada Syndrome (SABRUS)

Anat Milman  1 , Aviram Hochstadt  2 , Antoine Andorin  3   4 , Jean-Baptiste Gourraud  3   4 , Frederic Sacher  5 , Philippe Mabo  6 , Sung-Hwan Kim  7 , Giulio Conte  8 , Elena Arbelo  9 , Tsukasa Kamakura  10 , Takeshi Aiba  10 , Carlo Napolitano  4   11 , Carla Giustetto  12 , Isabelle Denjoy  4   13   14 , Jimmy J M Juang  15 , Shingo Maeda  16 , Yoshihide Takahashi  16 , Eran Leshem  17   18 , Yoav Michowitz  17 , Michael Rahkovich  17   19 , Camilla H Jespersen  4   20   21 , Yanushi D Wijeyeratne  4   22 , Jean Champagne  23 , Leonardo Calo  24 , Zhengrong Huang  25 , Yuka Mizusawa  4   26 , Pieter G Postema  4   27 , Ramon Brugada  28   29 , Arthur A M Wilde  4   26 , Gan-Xin Yan  30 , Elijah R Behr  4   22 , Jacob Tfelt-Hansen  4   20   21 , Kenzo Hirao  16 , Christian Veltmann  31 , Antoine Leenhardt  4   13   14 , Domenico Corrado  4   32 , Fiorenzo Gaita  12 , Silvia G Priori  4   11   33 , Kengo F Kusano  10 , Masahiko Takagi  34 , Pietro Delise  35 , Josep Brugada  9 , Pedro Brugada  4   8 , Gi-Byoung Nam  36 , Vincent Probst  3   4 , Bernard Belhassen  37
Affiliations

Time-to-first appropriate shock in patients implanted prophylactically with an implantable cardioverter-defibrillator: data from the Survey on Arrhythmic Events in BRUgada Syndrome (SABRUS)

Anat Milman et al. Europace. .

Erratum in

Abstract

Aims: Data on predictors of time-to-first appropriate implantable cardioverter-defibrillator (ICD) therapy in patients with Brugada Syndrome (BrS) and prophylactically implanted ICD's are scarce.

Methods and results: SABRUS (Survey on Arrhythmic Events in BRUgada Syndrome) is an international survey on 678 BrS patients who experienced arrhythmic event (AE) including 252 patients in whom AE occurred after prophylactic ICD implantation. Analysis was performed on time-to-first appropriate ICD discharge regarding patients' characteristics. Multivariate logistic regression models were utilized to identify which parameters predicted time to arrhythmia ≤5 years. The median time-to-first appropriate ICD therapy was 24.8 ± 2.8 months. A shorter time was observed in patients from Asian ethnicity (P < 0.05), those with syncope (P = 0.001), and those with Class IIa indication for ICD (P = 0.001). A longer time was associated with a positive family history of sudden cardiac death (P < 0.05). Multivariate Cox regression revealed shorter time-to-ICD therapy in patients with syncope [odds ratio (OR) 1.65, P = 0.001]. In 193 patients (76.6%), therapy was delivered during the first 5 years. Factors associated with this time were syncope (OR 0.36, P = 0.001), spontaneous Type 1 Brugada electrocardiogram (ECG) (OR 0.5, P < 0.05), and Class IIa indication (OR 0.38, P < 0.01) as opposed to Class IIb (OR 2.41, P < 0.01). A near-significant trend for female gender was also noted (OR 0.13, P = 0.052). Two score models for prediction of <5 years to shock were built.

Conclusion: First appropriate therapy in BrS patients with prophylactic ICD's occurred during the first 5 years in 76.6% of patients. Syncope and spontaneous Type 1 Brugada ECG correlated with a shorter time to ICD therapy.

Keywords: Appropriate therapy; Arrhythmic event; Brugada syndrome; Implantable cardioverter-defibrillator.

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