Prognosis after implantation of cardioverter-defibrillators in Korean patients with Brugada syndrome.

Abstract

PURPOSE:

Our study aims to analyze prognosis after implantable cardioverter-defibrillator (ICD) implantation in Korean patients with Brugada syndrome (BrS).

MATERIALS AND METHODS:

This was a retrospective study of BrS patients implanted with an ICD at one of four centers in Korea between January 1998 and April 2012. Sixty-nine patients (68 males, 1 female) were implanted with an ICD based on aborted cardiac arrest (n=38, 55%), history of syncope (n=17, 25%), or induced ventricular tachyarrhythmia on electrophysiologic study in asymptomatic patients (n=14, 20%). A family history of sudden cardiac death and a spontaneous type 1 electrocardiography (ECG) were noted in 13 patients (19%) and 44 patients (64%), respectively.

RESULTS:

During a mean follow-up of 59±46 months, 4.6±5.5 appropriate shocks were delivered in 19 patients (28%). Fourteen patients (20%) experienced 5.2±8.0 inappropriate shocks caused by supraventricular arrhythmia, lead failure, or abnormal sensing. Six patients were admitted for cardiac causes during follow-up, but no cardiac deaths occurred. An episode of aborted cardiac arrest was a significant predictor of appropriate shock, and the composite of cardiac events in the Cox proportional hazard model [hazard ratio (95% confidence interval) was 11.34 (1.31-97.94) and 4.78 (1.41-16.22), respectively]. However, a spontaneous type 1 ECG was not a predictor of cardiac events.

CONCLUSION:

Appropriate shock (28%) and inappropriate shock (20%) were noted during a mean follow-up of 59±46 months in Korean BrS patients implanted with an ICD. An episode of aborted cardiac arrest was the most powerful predictor of cardiac events.

• Authors: Myoung Kyun Son, Kyeongmin Byeon, Seung-Jung Park, June Soo Kim, Gi-Byoung Nam, Kee-Joon Choi, You-Ho Kim, Sang Weon Park, Young-Hoon Kim, Hyung Wook Park, Jeong Gwan Cho, Young Keun On
• Journal: Yonsei medical journal (Yonsei Med J) Vol. 55 Issue 1 Pg. 37-45 (Jan 2014) ISSN: 1976-2437 [Electronic] Korea (South)
• PMID: 24339285 (Publication Type: Journal Article)

Topics

• Adult
• Brugada Syndrome (therapy)
• Death, Sudden, Cardiac
• Defibrillators, Implantable
• Electrocardiography
• Female
• Humans
• Male
• Middle Aged
• Prognosis
• Republic of Korea
• Retrospective Studies
• Treatment Outcome