There were 59 patients (53 males, 89.8%) with a mean age of 44.1 years. At diagnosis 42 patients (71.2%) were symptomatic while 17 (28.8%) were asymptomatic. The indications for ICD implantation were: a history of
cardiac arrest (n = 11, 18.6%),
syncope (n = 31, 52.5%), inducible VF in asymptomatic patients (n = 14, 23.7%), and a family history of
sudden death (n = 3, 0.5%). The overall inducibility rates of VF were 89.2% and 93.3% among the symptomatic and asymptomatic patients, respectively (P = NS). During a follow-up of 4-160 (45 +/- 35) months, all patients (except one who died from
cancer) are alive. Five patients (8.4%), all with a history of
cardiac arrest, had appropriate ICD discharge. Conversely, none of the patients without prior
cardiac arrest had appropriate device
therapy during a 39 +/- 30 month follow-up. Complications were encountered in 19 patients (32%). Inappropriate shocks occurred in 16 (27.1%) due to lead failure/dislodgment (n = 5), T wave oversensing (n = 2), device failure (n = 1),
sinus tachycardia (n = 4), and
supraventricular tachycardia (n = 4). One patient suffered a
pneumothorax and another a brachial plexus injury during the implant procedure. One patient suffered a late (2 months) perforation of the right ventricle by the implanted lead. Eleven patients (18.6%) required a reintervention either for
infection (n = 1) or lead problems (n = 10). Eight patients (13.5%) required psychiatric assistance due to complications related to the ICD (mostly inappropriate shocks in 7 patients).
CONCLUSIONS: In this Israeli population with
Brugada syndrome treated with ICD, appropriate device
therapy was limited to
cardiac arrest survivors while none of the other patients including those with
syncope and/or inducible VF suffered an arrhythmic event. The overall complication rate was high.