Author + information
- Received May 16, 2018
- Revision received July 31, 2018
- Accepted September 6, 2018
- Published online February 18, 2019.
- Adem Dereci, MD,
- Sing-Chien Yap, MD, PhD and
- Arend F.L. Schinkel, MD, PhD∗ ()
- ↵∗Address for correspondence:
Dr. Arend F.L. Schinkel, Department of Cardiology, Thorax Center, Erasmus Medical Center, Room Rg429, 's-Gravendijkwal 230, 3015 CE Rotterdam, the Netherlands.
Objectives This study sought to summarize the clinical outcome of implantable cardioverter-defibrillator (ICD) therapy in patients with Brugada syndrome.
Background Brugada syndrome is characterized by cardiac conduction abnormalities and a high risk of ventricular arrhythmias that may result in sudden cardiac death. A complete overview of clinical outcome, appropriate and inappropriate interventions, and complications after ICD therapy in patients with Brugada syndrome is lacking.
Methods The online MEDLINE database was searched for published reports and yielded 828 studies on outcome and complications after ICD therapy in patients with Brugada syndrome. After careful evaluation, 22 studies including a total of 1,539 patients were included in the meta-analysis.
Results In total, 1,539 patients (mean age 45 years, 18% women) underwent ICD implantation for primary (79%) or secondary (21%) prevention of sudden cardiac death. During a mean follow-up of 4.9 years, the appropriate and inappropriate ICD intervention rates were 3.1 and 3.3 per 100 person-years, respectively. The cardiac mortality rate was 0.03 per 100 person-years and noncardiac mortality rate was 0.3 per 100 person-years. ICD-related complications per 100 person-years consisted of lead malfunction (1.6), psychological complication (1.3), infection (0.6), lead dislocation (0.4), and any complication (0.6).
Conclusions Patients with Brugada syndrome judged to be at high risk for ventricular arrhythmia may significantly benefit from ICD therapy, which is associated with an appropriate ICD intervention rate of 3.1 per 100 person-years and low cardiac and noncardiac mortality rates. Inappropriate ICD interventions and ICD-related complications may lead to considerable morbidity.
Dr. Yap has received research funding from Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
All authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received May 16, 2018.
- Revision received July 31, 2018.
- Accepted September 6, 2018.
- 2019 American College of Cardiology Foundation
This article requires a subscription or purchase to view the full text. If you are a subscriber or member, click Login or the Subscribe link (top menu above) to access this article.