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January 27, 2020Expert Review of Medical Devices

Sodium channel blocker-guided epicardial RF ablation shows promise as an ICD alternative in Brugada syndrome.

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Why the study?

Therapeutic options in symptomatic Brugada syndrome are limited to ICD and quinidine, while catheter ablation of the RVOT offers a potential cure, with different ablation strategies being utilized.

Does epicardial catheter ablation prevent ventricular arrhythmias in patients with symptomatic Brugada syndrome?

Design

Review

Key result

Epicardial radiofrequency substrate ablation guided by sodium channel blocker infusion is a promising tool for managing Brugada syndrome and may potentially become an alternative to ICD therapy.

Authors

ARAlessandro RizzoCACarlo de AsmundisPBPedro Brugada

Discussion

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Member takes

Overview

May reduce ICD dependence in symptomatic Brugada syndrome; leaves open need for randomized trials to confirm arrhythmia prevention.

Structured PICO

Does epicardial catheter ablation prevent ventricular arrhythmias in patients with symptomatic Brugada syndrome?

P
Population
Patients with symptomatic Brugada syndrome
I
Intervention
Catheter ablation (epicardial radiofrequency substrate ablation of the right ventricular outflow tract/right ventricle guided by sodium channel blocker infusion)
O
Outcome
Prevention of ventricular arrhythmias and sudden cardiac death

Epicardial radiofrequency substrate ablation guided by sodium channel blocker infusion is a promising strategy for managing symptomatic Brugada syndrome and may potentially serve as an alternative to ICD therapy.

Limitations

  • Ventricular fibrillation-triggering premature ventricular contractions are unpredictable and rarely present to be mapped
  • Endocardial mapping for Brugada syndrome substrates does not seem effective due to epicardial pathological substrate localization

Cite This Study

Rizzo et al. (2020) conducted a review in Brugada syndrome. Epicardial radiofrequency substrate ablation was evaluated. Epicardial radiofrequency substrate ablation guided by sodium channel blocker infusion is a promising tool for managing Brugada syndrome and may potentially become an alternative to ICD therapy.

synapsesocial.com/papers/6a0cfb7332f3c40b5ccbb03chttps://doi.org/10.1080/17434440.2020.1719831
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