Outcome After Implantation of a Cardioverter-Defibrillator in Patients With Brugada Syndrome

Sacher, Frédéric; Probst, Vincent; Maury, Philippe; Babuty, Dominique; Mansourati, Jacques; Komatsu, Yuki; Marquié, Christelle; Rosa, Antonio; Diallo, Abou; Cassagneau, Romain; Loizeau, Claire; Martins, Raphaël P.; Field, Michael E.; Derval, Nicolas; Miyazaki, Shinsuke; Denis, Arnaud; Nogami, Akihiko; Ritter, Philippe; Gourraud, Jean-Baptiste; Ploux, Sylvain; Rollin, Anne; Zemmoura, Adlane; Lamaison, D; Bordachar, Pierre; Pierre, Bertrand; Jaı̈s, Pierre; Pasquié, Jean‐Luc; Hocini, Mélèze; Defaye, Pascal; Boveda, Serge; Iesaka, Yoshito; Mabo, Philippe; Haı̈ssaguerre, Michel

doi:10.1161/circulationaha.106.628537

Cited by 276 publications

(83 citation statements)

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“…However, we also observed syncope in one patient with an implantable loop recorder with no documented ventricular arrhythmias. A multicentre study (17) recently reported on a large series of patients with BS implanted with ICDs, and the results were in accordance with the present findings. In the study (17), device interrogation showed no ventricular arrhythmia in 10% of the recurrent syncopal spells.…”

Section: Discussionsupporting

confidence: 93%

“…A multicentre study (17) recently reported on a large series of patients with BS implanted with ICDs, and the results were in accordance with the present findings. In the study (17), device interrogation showed no ventricular arrhythmia in 10% of the recurrent syncopal spells. ICD implantation in an asymptomatic population with a positive EPS was based on the report of the second consensus conference on BS (3) and on the Brugada brothers' studies (10,12,13).…”

Section: Discussionsupporting

confidence: 93%

“…In the present study, two patients had significant negative psychological effects secondary to ICD implantation. Sacher et al (17) reported a high risk (8.9%/year) of devicerelated complications (mostly inappropriate shocks) in patients with BS.…”

Section: Discussionmentioning

confidence: 99%

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The Brugada syndrome in Canada: A unique French-Canadian experience

Champagne

Philippon

Gilbert

et al. 2007

Canadian Journal of Cardiology

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B rugada syndrome (BS) involves a cardiac sodium channel abnormality and is associated with a high risk of ventricular arrhythmias and sudden cardiac death in individuals with a structurally normal heart. BS is mainly recognized in the specialized electrophysiology community. Characteristic electrocardiograms (ECGs) show a typical pattern of a right bundle branch block-like complex and ST segment elevation in leads V1 to V3 (1,2). In a recent consensus statement (3), three types of repolarization patterns were recognized: type 1 is diagnostic of BS and is characterized by an elevated, coved ST segment of 2 mm or greater followed by a negative T wave ( Figure 1); type 2 has a saddleback appearance with a high takeoff ST segment elevation of 2 mm or greater followed by an ST elevation of 1 mm or greater and either a positive or a THE QUEBEC HEART INSTITUTE ©2007 Pulsus Group Inc. All rights reserved The Brugada syndrome (BS) is a clinical entity involving cardiac sodium channelopathy, typical electrocardiogram (ECG) changes and predisposition to ventricular arrhythmia. This syndrome is mainly recognized by specialized cardiologists and electrophysiologists. Data regarding BS largely come from multicentre registries or Asian countries. The present report describes the Quebec Heart Institute experience, including the clinical characteristics and prognosis of native French-Canadian subjects with the Brugada-type ECG pattern. METHODS AND RESULTS: BS has been diagnosed in 35 patients (mean age 51±12 years) at the Quebec Heart Institute since 2001. Patients were referred from primary care physicians for ECG abnormalities, syncope or ventricular arrhythmia, or were diagnosed incidentally on an ECG obtained for other purposes. The abnormal ECG was recognized after a syncopal spell in four patients and during family screening in four patients. All of the others were incidental findings following a routine ECG. No patient had a family history of sudden cardiac death at younger than 45 years of age. In this population, right bundle branch block pattern with more than 2 mm ST segment elevation in leads V1 to V3 was recorded spontaneously in 25 patients and was induced by sodium blockers in 10 patients. The sodium channel blocker test was performed in 21 patients and was positive in 18 patients (86%). An electrophysiological study was performed in 20 of 35 patients, during which ventricular fibrillation was induced in five patients; three of the five patients were previously asymptomatic. An implantable cardioverter-defibrillator was implanted in six of 35 patients (17%), including three of four patients with a history of syncope. A loop recorder was implanted in three patients. After a mean follow-up of 36±18 months, one patient died from a noncardiac cause and one patient (with a history of syncope) received an appropriate shock from his implantable cardioverter-defibrillator. No event occurred in the asymptomatic population. CONCLUSIONS: BS is present in the French-Canadian population and is probably under-recognized. Long-...

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

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The Brugada syndrome in Canada: A unique French-Canadian experience

Champagne

Philippon

Gilbert

et al. 2007

Canadian Journal of Cardiology

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“…Sacher, et al found inappropriate shocks to be 2.5 times more common than appropriate shocks. 13) Thus, the arrhythmogenic substrate in Brugada syndrome may not be restricted to the ventricular level; similar changes may occur in the atria and could be the substrate for re-entrant atrial tachyarrhythmias.…”

Section: Discussionmentioning

confidence: 99%

“…Incidences of spontaneous atrial arrhythmias between 0% and 53% have been reported, [7][8][9][10][11][12][13][14][15][16][17][18] although the inducibility of atrial arrhythmia ranges from 3% to 100%. [7][8][9][10][11][12][13][14][15][16][17][18] Little is known about the relation between atrial arrhythmias and electrophysiologic backgrounds. We therefore compared depolarization and repolarization properties of the atria between patients with Brugada syndrome and control patients who underwent catheter ablation for tachyarrhythmias.…”

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confidence: 99%

Abnormal Atrial Repolarization and Depolarization Contribute to the Inducibility of Atrial Fibrillation in Brugada Syndrome

et al. 2010

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SummaryBrugada syndrome is often accompanied by atrial tachyarrhythmia, such as atrial fibrillation (AF). The aim of this study was to examine atrial vulnerability in patients with Brugada syndrome. Two groups of patients were compared: 18 patients with Brugada syndrome (Brugada syndrome group) and 11 age-matched patients with neither organic heart disease nor AF episodes (control group). Programmed electrical stimulation was performed from the right atrium (RA), and the effective refractory period of the right atrium (ERP-RA), interatrial conduction time (IACT), monophasic action potentials (MAPs) at the high RA, and the inducibility of AF lasting > 30 seconds were studied. MAP duration at 80% repolarization (MAPD 80 ) was calculated. AF was induced with a single extrastimulus or double extrastimuli in all patients with Brugada syndrome but in none of the control patients. The ERP-RA did not differ between the groups. IACT at the shortest diastolic interval was significantly increased in the Brugada syndrome group compared to that in the control group. The maximum slope of the MAPD 80 restitution curve was significantly steeper in the Brugada syndrome group than in the control group (2.4 ± 2.0 versus 0.82 ± 0.36, P < 0.02). Ventricular fibrillation was induced with ventricular programmed stimulation in all Brugada syndrome patients. Both abnormal interatrial conduction and steep restitution of action potential duration may contribute to the atrial arrhythmogenicity in Brugada syndrome. (Int Heart J 2010; 51: 159-165)

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Mortality Among Patients With Early-Onset Atrial Fibrillation and Rare Variants in Cardiomyopathy and Arrhythmia Genes

Yoneda

Anderson

et al. 2022

JAMA Cardiol

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IMPORTANCE Patients with early-onset atrial fibrillation (AF) are enriched for rare variants in cardiomyopathy and arrhythmia genes. The clinical significance of these rare variants in patients with early-onset AF is unknown.OBJECTIVE To assess the association between rare variants in cardiomyopathy and arrhythmia genes detected in patients with early-onset AF and time to death. DESIGN, SETTING, AND PARTICIPANTSThis prospective cohort study included participants with AF diagnosed before 66 years of age who underwent whole-genome sequencing through the National Heart, Lung and Blood Institute's Trans-Omics for Precision Medicine program.

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Outcome After Implantation of a Cardioverter-Defibrillator in Patients With Brugada Syndrome

Cited by 276 publications

References 22 publications

The Brugada syndrome in Canada: A unique French-Canadian experience

The Brugada syndrome in Canada: A unique French-Canadian experience

Abnormal Atrial Repolarization and Depolarization Contribute to the Inducibility of Atrial Fibrillation in Brugada Syndrome

Mortality Among Patients With Early-Onset Atrial Fibrillation and Rare Variants in Cardiomyopathy and Arrhythmia Genes

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