Implantable Cardioverter-Defibrillators in Children and Adolescents With Brugada Syndrome.
J Am Coll Cardiol
; 71(2): 148-157, 2018 01 16.
Article
in En
| MEDLINE
| ID: mdl-29325638
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.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Electric Countershock
/
Death, Sudden, Cardiac
/
Tachycardia, Ventricular
/
Defibrillators, Implantable
/
Brugada Syndrome
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
/
Child
/
Female
/
Humans
/
Male
Country/Region as subject:
Europa
Language:
En
Journal:
J Am Coll Cardiol
Year:
2018
Document type:
Article