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. 2023 May;38(5):680-688.
doi: 10.1007/s00380-022-02204-x. Epub 2022 Nov 24.

Subcutaneous versus transvenous implantable cardioverter-defibrillator among drug-induced type-1 ECG pattern Brugada syndrome: a propensity score matching analysis from IBRYD study

Vincenzo Russo #  1 , Alfredo Caturano #  2 , Federico Guerra  3 , Federico Migliore  4 , Giuseppe Mascia  5 , Andrea Rossi  6 , Martina Nesti  7 , Vincenzo Ezio Santobuono  8 , Emilio Attena  9 , Gianfranco Tola  10 , Luigi Sciarra  11 , Giulio Conte  12 , Alessandro Paoletti Perini  13 , Pietro Francia  14 , Gregory Dendramis  15 , Zefferino Palamà  16 , Stefano Albani  17 , Andrea Ottonelli Ghidini  18 , Leonardo Calò  11 , Antonio D'Onofrio  19 , Enrico Baldi  20 ; IBRYD Study Group
Collaborators, Affiliations

Subcutaneous versus transvenous implantable cardioverter-defibrillator among drug-induced type-1 ECG pattern Brugada syndrome: a propensity score matching analysis from IBRYD study

Vincenzo Russo et al. Heart Vessels. 2023 May.

Erratum in

Abstract

No real-world data are available about the complications rate in drug-induced type 1 Brugada Syndrome (BrS) patients with an implantable cardioverter-defibrillator (ICD). Aim of our study is to compare the device-related complications, infections, and inappropriate therapies among drug-induced type 1 BrS patients with transvenous- ICD (TV-ICD) versus subcutaneous-ICD (S-ICD). Data for this study were sourced from the IBRYD (Italian BRugada sYnDrome) registry which includes 619 drug-induced type-1 BrS patients followed at 20 Italian tertiary referral hospitals. For the present analysis, we selected 258 consecutive BrS patients implanted with ICD. 198 patients (76.7%) received a TV-ICD, while 60 a S-ICD (23.4%). And were followed-up for a median time of 84.3 [46.5-147] months. ICD inappropriate therapies were experienced by 16 patients (6.2%). 14 patients (7.1%) in the TVICD group and 2 patients (3.3%) in S-ICD group (log-rank P = 0.64). ICD-related complications occurred in 31 patients (12%); 29 (14.6%) in TV-ICD group and 2 (3.3%) in S-ICD group (log-rank P = 0.41). ICD-related infections occurred in 10 patients (3.88%); 9 (4.5%) in TV-ICD group and 1 (1.8%) in S-ICD group (log-rank P = 0.80). After balancing for potential confounders using the propensity score matching technique, no differences were found in terms of clinical outcomes between the two groups. In a real-world setting of drug-induced type-1 BrS patients with ICD, no significant differences in inappropriate ICD therapies, device-related complications, and infections were shown among S-ICD vs TV-ICD. However, a reduction in lead-related complications was observed in the S-ICD group. In conclusion, our evidence suggests that S-ICD is at least non-inferior to TV-ICD in this population and may also reduce the risk of lead-related complications which can expose the patients to the necessity of lead extractions.

Keywords: Brugada syndrome; Drug-induced type 1 Brugada syndrome; ICD-related complication; ICD-related infection; Implantable cardioverter-defibrillator; Inappropriate shock; Subcutaneous cardioverter-defibrillator; Sudden cardiac death; Transvenous cardioverter-defibrillator.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Kaplan–Meier curvecomparing survival from inappropriate ICD therapies among S-ICD vs TV-ICD groups in unmatched (A) and matched (B) cohorts
Fig. 2
Fig. 2
Kaplan–Meier curvecomparing survival from ICD-related complications among S-ICD vs TV-ICD groups in unmatched (A) and matched (B) cohorts
Fig. 3
Fig. 3
Kaplan–Meier curvecomparing survival from ICD-related infections among S-ICD vs TV-ICD groups in unmatched (A) and matched (B) cohorts
See this image and copyright information in PMC

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