Subcutaneous versus transvenous implantable cardioverter-defibrillator among drug-induced type-1 ECG pattern Brugada syndrome: a propensity score matching analysis from IBRYD study

Russo, Vincenzo; Caturano, Alfredo; Guerra, Federico; Migliore, Federico; Mascia, Giuseppe; Rossi, Alessandro; Nesti, Martina; Santobuono, Vincenzo Ezio; Attena, Emilio; Tola, G; Sciarra, Luigi; Conte, Giulio; Perini, Alessandro Paoletti; Francia, Pietro; Dendramis, Gregory; Palamà, Zefferino; Albani, Stefano; Ghidini, Andrea Ottonelli; Calò, Leonardo; D’Onofrio, Antonio; Baldi, Enrico; Nigro, Gerardo; Sasso, Ferdinando Carlo; Barca, Luca; Porto, Italo; Notarstefano, Pasquale; Ruocco, Maria Antonietta; Pardo, Livia Franchetti; Adducci, Carmen; Berlier, Nicola; Sarubbi, Berardo; Vicentini, Alessandro; Floris, Roberto; Romeo, Emanuele; Golino, Paolo

doi:10.1007/s00380-022-02204-x

Cited by 12 publications

(8 citation statements)

References 25 publications

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“…A recent study involving 258 patients has revealed no significant differences in inappropriate ICD therapies, device-related complications, or infections between the population of drug-induced type-1 BrS patients with subcutaneous-ICD and those with transvenous-ICD. Furthermore, there's evidence suggesting that the use of subcutaneous-ICD may potentially reduce the risk of complications related to lead in patients with ICDs ( 35 ).…”

Section: Discussionmentioning

confidence: 99%

Case report: State-of-the-art risk-modifying treatment of sudden cardiac death in an asymptomatic patient with a mutation in the SCN5A gene and a review of the literature

Brlek,

Pavelić,

Mešić

et al. 2023

Front. Cardiovasc. Med.

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Brugada syndrome is a rare hereditary disorder characterized by distinct ECG findings, complex genetics, and a high risk of sudden cardiac death. Recognition of the syndrome is crucial as it represents a paradigm of sudden death tragedy in individuals at the peak of their lives. Notably, Brugada syndrome accounts for more than 20% of sudden cardiac deaths in individuals with structurally normal hearts. Although this syndrome follows an autosomal dominant inheritance pattern, it is more prevalent and severe in males. Diagnosis is primarily based on the characteristic ECG pattern observed in the right precordial leads. Mutations in the SCN5A gene, resulting in loss of function, are the most common genetic cause. We presented a 36-year-old proband with a family history of sudden cardiac death. Although the patient was asymptomatic for Brugada syndrome, his father had experienced sudden death at the age of 36. The proband was admitted to St. Catherine's Specialty Hospital where blood was taken and subjected to next-generation sequencing (NGS) using a “Sudden cardiac death” panel. The analysis identified a pathogenic variant in the SCN5A gene [c.4222G > A(p.Gly1408Arg)], which is associated with autosomal dominant Brugada syndrome. Based on the positive genetic test result, the patient was referred for further examination. ECG with modified precordial lead positioning confirmed the presence of the Brugada phenotype, displaying the type-2 and type-1 ECG patterns. Therefore, we made the diagnosis and decided to implant an implantable cardioverter-defibrillator (ICD) based on the results of broad genetic NGS testing, diagnostic criteria (ECG), and considering the high burden of sudden cardiac death in the patient's family, as well as his concerns that limited his everyday activities. This case shows that genetics and personalized medicine hold immense potential in the primary prevention, diagnosis, and treatment of Brugada syndrome and sudden cardiac death.

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Section: Discussionmentioning

confidence: 99%

Case report: State-of-the-art risk-modifying treatment of sudden cardiac death in an asymptomatic patient with a mutation in the SCN5A gene and a review of the literature

Brlek,

Pavelić,

Mešić

et al. 2023

Front. Cardiovasc. Med.

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“…Currently, the increasing use of subcutaneous ICDs (S-ICD) raises questions about the efficacy of such devices in cardiomyopathies and how to evaluate clinical arrhythmic endpoints. Although no clinical trial was conducted specifically in the setting of cardiomyopathies, substantial evidence suggests that S-ICD efficacy appears non-inferior to transvenous ICDs in terms of preventing SCD and all-cause mortality [42,43]. Moreover, the inability of S-ICD to perform ATP was PLOS ONE not associated with a higher risk of MAE.…”

Section: Limitationsmentioning

confidence: 99%

Deep learning-based prediction of major arrhythmic events in dilated cardiomyopathy: A proof of concept study

Corianò,

Lanera,

De Michieli

et al. 2024

PLoS ONE

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Prediction of major arrhythmic events (MAEs) in dilated cardiomyopathy represents an unmet clinical goal. Computational models and artificial intelligence (AI) are new technological tools that could offer a significant improvement in our ability to predict MAEs. In this proof-of-concept study, we propose a deep learning (DL)-based model, which we termed Deep ARrhythmic Prevention in dilated cardiomyopathy (DARP-D), built using multidimensional cardiac magnetic resonance data (cine videos and hypervideos and LGE images and hyperimages) and clinical covariates, aimed at predicting and tracking an individual patient’s risk curve of MAEs (including sudden cardiac death, cardiac arrest due to ventricular fibrillation, sustained ventricular tachycardia lasting ≥30 s or causing haemodynamic collapse in <30 s, appropriate implantable cardiac defibrillator intervention) over time. The model was trained and validated in 70% of a sample of 154 patients with dilated cardiomyopathy and tested in the remaining 30%. DARP-D achieved a 95% CI in Harrell’s C concordance indices of 0.12–0.68 on the test set. We demonstrate that our DL approach is feasible and represents a novelty in the field of arrhythmic risk prediction in dilated cardiomyopathy, able to analyze cardiac motion, tissue characteristics, and baseline covariates to predict an individual patient’s risk curve of major arrhythmic events. However, the low number of patients, MAEs and epoch of training make the model a promising prototype but not ready for clinical usage. Further research is needed to improve, stabilize and validate the performance of the DARP-D to convert it from an AI experiment to a daily used tool.

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“… 5 Moreover, a recent study has shown no significant differences in inappropriate ICD therapies, device-related complications, and infections between S-ICD and TV-ICD among BrS patients. 6 …”

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confidence: 99%

When the dual-chamber pacing system is the optimal choice for Brugada patients in need of implantable cardiac defibrillator

Russo,

Cantiello,

Caturano

2024

European Heart Journal - Case Reports

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This letter discusses key points from Esposito et al.'s case report on a Brugada Syndrome (BrS) patient treated with S-ICD and later TV-ICD due to recurrent syncope. It highlights the significance of asystole in BrS-related. Additionally, it recommends dual-chamber TV-ICD systems with CLS algorithms for optimal management, citing their efficacy in reducing syncopal recurrences. Finally, it underscores the importance of considering reflex bradyarrhythmias in device selection for BrS patients at increased sudden cardiac death risk.

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Subcutaneous versus transvenous implantable cardioverter-defibrillator among drug-induced type-1 ECG pattern Brugada syndrome: a propensity score matching analysis from IBRYD study

Cited by 12 publications

References 25 publications

Case report: State-of-the-art risk-modifying treatment of sudden cardiac death in an asymptomatic patient with a mutation in the SCN5A gene and a review of the literature

Case report: State-of-the-art risk-modifying treatment of sudden cardiac death in an asymptomatic patient with a mutation in the SCN5A gene and a review of the literature

Deep learning-based prediction of major arrhythmic events in dilated cardiomyopathy: A proof of concept study

When the dual-chamber pacing system is the optimal choice for Brugada patients in need of implantable cardiac defibrillator

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