|
Title
|
|
|
|
Implantable cardioverter-defibrillators in children and adolescents with Brugada syndrome
| |
|
Author
|
|
|
|
| |
|
Abstract
|
|
|
|
| BACKGROUND Young patients presenting with symptomatic Brugada syndrome have very high risks for ventricular arrhythmias and should be carefully considered for implantable cardioverter-defibrillator (ICD) placement. However, this therapy is associated with high rates of inappropriate shocks and device-related complications. OBJECTIVES This study investigated clinical features, management, and long-term follow-up of young patients with Brugada syndrome and ICD. METHODS Patients diagnosed with Brugada syndrome, who underwent implantation of an ICD at an age of <= 20 years, were studied. RESULTS The study included 35 consecutive patients. The mean age at ICD placement was 13.9 +/- 6.2 years. Ninety-two percent were symptomatic; 29% presented with aborted sudden cardiac death and 63% with syncope. During a mean follow-up period of 88 months, sustained ventricular arrhythmias were treated by the ICD in 9 patients (26%), including shocks in 8 patients (23%) and antitachycardia pacing in 1 patient (3%). Three patients (9%) died in an electrical storm. Seven patients (20%) experienced inappropriate shocks, and 5 patients (14%) had device-related complications. Aborted sudden cardiac death and spontaneous type I electrocardiogram were identified as independent predictors of appropriate shock occurrence. CONCLUSIONS ICD therapy is an effective strategy in young patients with symptomatic Brugada syndrome, treating potentially lethal arrhythmias in >25% of patients during follow-up. Appropriate shocks were significantly associated with previously aborted sudden cardiac death and spontaneous type I electrocardiograms. However, ICDs are frequently associated with complications and inappropriate shocks, both of which remain high regardless of careful device implantation and programming. (c) 2018 by the American College of Cardiology Foundation. |
| |
|
Language
|
|
|
|
English
| |
|
Source (journal)
|
|
|
|
Journal of the American College of Cardiology. - New York, N.Y.
| |
|
Publication
|
|
|
|
New York, N.Y.
:
2018
| |
|
ISSN
|
|
|
|
0735-1097
| |
|
DOI
|
|
|
|
10.1016/J.JACC.2017.10.082
| |
|
Volume/pages
|
|
|
|
71
:2
(2018)
, p. 148-157
| |
|
ISI
|
|
|
|
000419597100007
| |
|
Pubmed ID
|
|
|
|
29325638
| |
|
Full text (Publisher's DOI)
|
|
|
|
| |
|