Long-Term Efficacy of Implantable Cardioverter-Defibrillators in Brugada

Beneficial; however, ICDs frequently associated with complications and inappropriate shocks
Beneficial; however, ICDs frequently associated with complications and inappropriate shocks

HealthDay News — Implantable cardioverter-defibrillators (ICDs) are effective in young patients with symptomatic Brugada syndrome, according to a study published in the January 16 issue of the Journal of the American College of Cardiology.

M. Cecilia Gonzalez Corcia, MD, from Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, and colleagues investigated clinical features, management, and long-term follow-up (mean, 88 months) of 35 young patients (mean age, 13.9 years) with Brugada syndrome who had an ICD implanted at an age of ≤20 years. 

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The researchers found that the vast majority of patients (92%) were symptomatic, including 29% presented with aborted sudden cardiac death and 63% with syncope. ICDs treated sustained ventricular arrhythmias in nine patients, including shocks in eight patients (23%) and antitachycardia pacing in one patient. An electrical storm caused death in three patients, while seven patients experienced inappropriate shocks and five patients had device-related complications. Independent predictors of appropriate shock occurrence were aborted sudden cardiac death and spontaneous type I electrocardiogram.

"ICD therapy is an effective strategy in young patients with symptomatic Brugada syndrome, treating potentially lethal arrhythmias in >25% of patients during follow-up," the authors write.

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