Benefit of implantable cardioverter-defibrillator therapy after generator replacement in patients with Brugada syndrome.

Abstract

BACKGROUND:

An implantable cardioverter-defibrillator (ICD) is the only proven effective therapeutic strategy for patients with Brugada syndrome (BS). However, it is controversial whether the device should be replaced even in patients who had never experienced appropriate ICD therapy until the time of generator replacement.

METHODS AND RESULTS:

This was a nationwide, multicenter retrospective study that enrolled patients who were diagnosed with BS and had an ICD implantation between January 1998 and April 2014. Appropriate ICD therapies administered for ventricular tachyarrhythmia were evaluated during follow-up. A total of 117 patients (age 43 ± 12 years, male 115 [98.3%]) were enrolled, and the mean follow-up duration was 6.0 ± 4.1 years. Thirty-seven (31.6%) patients had experienced appropriate ICD therapy during follow-up. Of all patients, 46 underwent replacement of the device. After the first generator replacement, the incidence of appropriate ICD therapy remained as high as 65.2% in patients who previously experienced appropriate ICD therapy before generator replacement. In 30 patients who did not experience any cardiac events until the first generator change, two (8.7%) had an episode of appropriate ICD therapy afterwards.

CONCLUSIONS:

No episode of ICD therapy before generator replacement could not guarantee a safe clinical course. ICD generator replacement should be considered even in patients without ICD therapy before.

• Authors: Ju Youn Kim, Sung-Hwan Kim, Sung Su Kim, Ki Hong Lee, Hyung-Wook Park, Jeong-Gwan Cho, Jae-Sun Uhm, Boyoung Joung, Hui-Nam Pak, Moon-Hyoung Lee, Seung-Jung Park, Young Keun On, June Soo Kim, Hong Euy Lim, Jaemin Shim, Jong-Il Choi, Sang Weon Park, Young-Hoon Kim, Woo Seok Lee, Jun Kim, Gi-Byoung Nam, Kee-Joon Choi, You-Ho Kim, Yong-Seog Oh, Man-Young Lee, Tai-Ho Rho
• Journal: International journal of cardiology (Int J Cardiol) Vol. 187 Pg. 340-4 ( 2015) ISSN: 1874-1754 [Electronic] Netherlands
• PMID: 25839639 (Publication Type: Clinical Study, Journal Article, Multicenter Study)
• Copyright: Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Topics

• Adult
• Brugada Syndrome (therapy)
• Defibrillators, Implantable
• Female
• Humans
• Male
• Middle Aged
• Retrospective Studies