Catheter ablation as an adjunctive therapy to ICD implantation in Brugada Syndrome.

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  • Additional Information
    • Source:
      Publisher: Oxford University Press Country of Publication: England NLM ID: 101677796 Publication Model: Print Cited Medium: Internet ISSN: 2058-1742 (Electronic) Linking ISSN: 20581742 NLM ISO Abbreviation: Eur Heart J Qual Care Clin Outcomes Subsets: MEDLINE
    • Publication Information:
      Original Publication: Oxford : Oxford University Press, [2015]-
    • Subject Terms:
      Brugada Syndrome*/physiopathology ; Brugada Syndrome*/complications ; Brugada Syndrome*/surgery ; Defibrillators, Implantable* ; Catheter Ablation*/methods ; Electrocardiography*; Humans ; Death, Sudden, Cardiac/prevention & control ; Death, Sudden, Cardiac/etiology ; Combined Modality Therapy ; Treatment Outcome
    • Abstract:
      Background: Brugada Syndrome (BrS) is a life-threatening cardiac arrhythmia disorder associated with an increased risk of ventricular arrhythmias (VAs) and sudden cardiac death. Current management primarily relies on implantable cardioverter-defibrillators (ICDs), but patients may experience ICD shocks. Catheter ablation (CA) has emerged as a potential intervention to target the arrhythmogenic substrate. This systematic review aims to evaluate the safety and efficacy of CA in BrS patients.
      Methods and Results: Studies with BrS patients undergoing CA for VAs were included. Fourteen studies that involved a total population of 709 BrS patients, with CA performed in 528 of them, were included. CA resulted in the non-inducibility of VAs in 91% (95% CI: 83-99, I2 = 76%) and resolution of type 1 ECG Brugada pattern in 88% (95% CI: 81-96.2, I2 = 91%) of the patients. After a mean follow-up of 30.7 months, 87% (95% CI: 80-94, I2 = 82%) of patients remained free from VAs. The incidence of VAs during follow-up was significantly lower in the ablation cohort in comparison to the group receiving only ICD therapy (OR = 0.03, 95% CI: 0.01-0.12, I2 = 0%).
      Conclusion: CA shows potential as a therapeutic approach to reduce VAs and improve outcomes in BrS patients. While further research with a long follow-up period is required to confirm these findings, it represents a valuable tool as an add-on intervention to ICD implantation in BrS patients with a high burden of VAs.
      (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
    • Comments:
      Comment in: Eur Heart J Qual Care Clin Outcomes. 2024 Nov 5;10(7):565-567. doi: 10.1093/ehjqcco/qcae065. (PMID: 39076004)
    • Contributed Indexing:
      Keywords: Brugada Syndrome; Catheter ablation; Meta-analysis; Sudden cardiac death; Systematic review
    • Publication Date:
      Date Created: 20240522 Date Completed: 20241105 Latest Revision: 20241105
    • Publication Date:
      20250114
    • Accession Number:
      10.1093/ehjqcco/qcae040
    • Accession Number:
      38777620