Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Oct;42(10):958-965.
doi: 10.1002/clc.23247. Epub 2019 Aug 22.

Implantable cardioverter-defibrillator in Brugada syndrome: Long-term follow-up

Ibrahim El-Battrawy  1   2 , Gretje Roterberg  1 , Volker Liebe  1 , Uzair Ansari  1 , Siegfried Lang  1   2 , Xiaobo Zhou  1   2 , Martin Borggrefe  1   2 , Ibrahim Akin  1   2
Affiliations

Implantable cardioverter-defibrillator in Brugada syndrome: Long-term follow-up

Ibrahim El-Battrawy et al. Clin Cardiol. 2019 Oct.

Abstract

Background: Brugada syndrome (BrS) is associated with sudden cardiac death (SCD). Although implantable cardioverter-defibrillator (ICD) implantation is recommended, the long-term outcomes and follow-up data with regard to ICD complications have led to controversy.

Hypothesis: In the present study, we described the data assimilated in a total of 11 studies, analyzing the outcome in 747 BrS patients receiving ICD.

Methods: Data were performed and analyzed after a systematic review of literature compiled from a thorough database search (PubMed, Web of Science, Cochrane Library, and Cinahl).

Results: The mean age of patients receiving ICD was (43.1 ± 13.4, 82.5% males, 46.6% spontaneous BrS type I). Around 15.3% of the patients were admitted due to SCD and 10.4% suffered from atrial arrhythmia. Appropriate shocks were documented in 18.1% of the patients over a mean follow-up period of 82.3 months (47.5-110.4). The following complications were recorded: lead failure and fracture (5.4%), lead perforation (0.7%), lead dislodgement (1.7%), infection (3.9%), pain (0.4%), subclavian vein thrombosis (0.3%), pericardial effusion (0.1%), endocarditis (0.1%), psychiatric problems (1.5%), pneumothorax (0.7%). Inappropriate shocks were documented in 18.1% of the patients. The management of inappropriate shocks was achieved by pulmonary vein isolation (0.5%), drug treatment with sotalol (1.3%) or sotalol with beta-blocker (0.3%) and hydroquinidine (0.1%).

Conclusions: ICD therapy in BrS is associated with relevant ICD-related complications including a substantial risk of inappropriate shocks more frequently in symptomatic BrS patients.

Keywords: Brugada; complications; devices; outcome.

PubMed Disclaimer

Conflict of interest statement

The authors declare no potential conflict of interests.

Figures

Figure 1
Figure 1
flowchart of recruitment criteria of the present study. Finally, 747 patients were included from 11 studies
Figure 2
Figure 2
Comparison of different studies showing the outcome of implantable cardioverter‐defibrillator (ICD) in 1201 patients
Figure 3
Figure 3
Rate of appropriate and inappropriate implantable cardioverter‐defibrillator (ICD) shocks related to the symptomatic state
Figure 4
Figure 4
Rate of appropriate and inappropriate implantable cardioverter‐defibrillator (ICD) shocks related to the symptomatic state
See this image and copyright information in PMC

References

    1. Amin AS, Verkerk AO, Bhuiyan ZA, Wilde AA, Tan HL. Novel Brugada syndrome‐causing mutation in ion‐conducting pore of cardiac Na+ channel does not affect ion selectivity properties. Acta Physiol Scand. 2005;185(4):291‐301. - PubMed
    1. Morita H, Nagase S, Kusano K, Ohe T. Spontaneous T wave alternans and premature ventricular contractions during febrile illness in a patient with Brugada syndrome. J Cardiovasc Electrophysiol. 2002;13(8):816‐818. - PubMed
    1. Casado‐Arroyo R, Berne P, Rao JY, Rodriguez‐Manero M, Levinstein M, et al. Long‐term trends in newly diagnosed Brugada syndrome: implications for risk stratification. J Am Coll Cardiol. 2016;68(6):614‐623. - PubMed
    1. Brugada J, Brugada R, Brugada P. Determinants of sudden cardiac death in individuals with the electrocardiographic pattern of Brugada syndrome and no previous cardiac arrest. Circulation. 2003;108(25):3092‐3096. - PubMed
    1. Pappone C, Brugada J, Vicedomini G, et al. Electrical substrate elimination in 135 consecutive patients with Brugada syndrome. Circ Arrhythm Electrophysiol. 2017;10(5):e005053. - PubMed

Publication types