Improved Risk Stratification of Patients With Brugada Syndrome by the New Japanese Circulation Society Guideline　- A Multicenter Validation Study.

Abstract

BACKGROUND:

The new guideline (NG) published by the Japanese Circulation Society (JCS) places emphasis on previous arrhythmic syncope and inducibility of ventricular fibrillation (VF) by ≤2 extrastimuli during programmed electrical stimulation (PES) for deciding the indication of an implantable cardioverter-defibrillator in patients with Brugada syndrome (BrS). This study evaluated the usefulness of the NG and compared it with the former guideline (FG) for risk stratification of patients with BrS.Methods and Results:This was a multicenter (7 Japanese hospitals) retrospective study involving 234 patients with BrS who underwent PES at baseline (226 males; mean age at diagnosis: 44.9±13.4 years). At diagnosis, 46 patients (20%) had previous VF, 100 patients (43%) had previous syncope, and 88 patients (37%) were asymptomatic. We evaluated the difference in the incidence of VF in each indication according to the new and FGs. During the follow-up period (mean: 6.9±5.2 years), the incidence of VF was higher in patients with Class IIa indication according to the NG (NG: 16/45 patients [35.6%] vs. FG: 16/104 patients [15.4%]), while the incidence of VF in patients with other than class I or IIa indication was similarly low in both guidelines (NG: 2/143 patients [1.4%] vs. FG: 2/84 patients [2.4%]).

CONCLUSIONS:

This study validated the usefulness of the NG for risk stratification of BrS patients.

• Authors: Akinori Wakamiya, Tsukasa Kamakura, Tetsuji Shinohara, Kenji Yodogawa, Nobuyuki Murakoshi, Hiroshi Morita, Naohiko Takahashi, Yasuya Inden, Wataru Shimizu, Akihiko Nogami, Minoru Horie, Kenzaburo Nakajima, Naoya Kataoka, Mitsuru Wada, Kenichiro Yamagata, Kohei Ishibashi, Yuko Inoue, Koji Miyamoto, Satoshi Nagase, Takashi Noda, Takeshi Aiba, Satoshi Yasuda, Masaki Ieda, Kengo Kusano
• Journal: Circulation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 84 Issue 12 Pg. 2158-2165 (11 25 2020) ISSN: 1347-4820 [Electronic] Japan
• PMID: 33071242 (Publication Type: Journal Article, Multicenter Study, Validation Study)

Topics

• Adult
• Brugada Syndrome (therapy)
• Defibrillators, Implantable
• Electrocardiography
• Female
• Humans
• Japan (epidemiology)
• Male
• Middle Aged
• Practice Guidelines as Topic
• Retrospective Studies
• Risk Assessment
• Syncope
• Ventricular Fibrillation (therapy)