Key result
Patients with Brugada syndrome had a higher prevalence of high defibrillation energy requirements precluding a 10-J safety margin compared to those with structural heart disease (18% vs 0%).
Why the study?
Do patients with Brugada syndrome have different defibrillation energy requirements and electrophysiologic characteristics compared to patients with structural heart disease?
Observational (n=51)
Do patients with Brugada syndrome have different defibrillation energy requirements and electrophysiologic characteristics compared to patients with structural heart disease?
Absolute Event Rate: 18% vs 0%
Patients with Brugada syndrome exhibit a higher prevalence of high defibrillation energy requirements and shorter ventricular refractoriness compared to patients with structural heart disease, which may explain unsuccessful internal defibrillation.
Higher defibrillation thresholds may occur in Brugada syndrome; observational data leaves open tailored ICD testing or device selection.
INTRODUCTION: In patients with Brugada syndrome, implantable cardioverter defibrillator (ICD) is the only reliable treatment to prevent sudden death though, in some cases, internal defibrillation may be unsuccessful. The aim of this study was to examine the determinants of defibrillation failure, with a focus on electrophysiologic characteristics. METHODS: The study included 51 patients treated with ICD: 22 with Brugada syndrome and 29 with structural heart disease (SHD). The prevalence of defibrillation energy requirement precluding the programming of a 10-J safety margin, the mean right ventricular effective refractory period (ERP), and mean induced ventricular fibrillation cycle length (VFCL) from the stored ICD electrograms, were compared between the two patient groups. RESULTS: High defibrillation requirements were observed in 18% of patients with Brugada syndrome versus 0% of patients with SHD. However, the patients with SHD had larger heart size than those with Brugada syndrome. Mean VFCL and mean ERP were both significantly shorter in patients with Brugada syndrome than in patients with SHD, and ERP and VFCL were significantly correlated. CONCLUSION: Patients with Brugada syndrome have a high prevalence of high defibrillation energy requirement, and short ventricular ERP and VFCL.
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Watanabe et al. (2005) conducted an observational in Brugada syndrome and structural heart disease (n=51). Brugada syndrome vs. Structural heart disease was evaluated on High defibrillation energy requirement precluding a 10-J safety margin. Patients with Brugada syndrome had a higher prevalence of high defibrillation energy requirements precluding a 10-J safety margin compared to those with structural heart disease (18% vs 0%).
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