Key result
Catheter ablation cuts ventricular arrhythmias ~97% vs ICD alone in Brugada syndrome patients.
Why the study?
ICDs are primary management in Brugada Syndrome but patients may experience shocks, leading catheter ablation to emerge as a potential substrate-targeting intervention requiring evaluation for safety and efficacy.
Does catheter ablation reduce the incidence of ventricular arrhythmias in Brugada Syndrome patients compared to ICD therapy alone?
Systematic Review (n=709)
Does catheter ablation reduce the incidence of ventricular arrhythmias in Brugada Syndrome patients compared to ICD therapy alone?
Effect estimate: OR 0.03 (95% CI 0.01-0.12)
Catheter ablation as an adjunct to ICD therapy significantly reduces the incidence of ventricular arrhythmias in patients with Brugada Syndrome.
Supports adjunctive catheter ablation with ICD to reduce VA risk in Brugada syndrome; extends pooled evidence from available studies.
BACKGROUND: Brugada Syndrome (BrS) is a life-threatening cardiac arrhythmia disorder associated with an increased risk of ventricular arrhythmias (VAs) and sudden cardiac death. Current management primarily relies on implantable cardioverter-defibrillators (ICDs), but patients may experience ICD shocks. Catheter ablation (CA) has emerged as a potential intervention to target the arrhythmogenic substrate. This systematic review aims to evaluate the safety and efficacy of CA in BrS patients. METHODS AND RESULTS: Studies with BrS patients undergoing CA for VAs were included. Fourteen studies that involved a total population of 709 BrS patients, with CA performed in 528 of them, were included. CA resulted in the non-inducibility of VAs in 91% (95% CI: 83-99, I2 = 76%) and resolution of type 1 ECG Brugada pattern in 88% (95% CI: 81-96.2, I2 = 91%) of the patients. After a mean follow-up of 30.7 months, 87% (95% CI: 80-94, I2 = 82%) of patients remained free from VAs. The incidence of VAs during follow-up was significantly lower in the ablation cohort in comparison to the group receiving only ICD therapy (OR = 0.03, 95% CI: 0.01-0.12, I2 = 0%). CONCLUSION: CA shows potential as a therapeutic approach to reduce VAs and improve outcomes in BrS patients. While further research with a long follow-up period is required to confirm these findings, it represents a valuable tool as an add-on intervention to ICD implantation in BrS patients with a high burden of VAs.
No takes yet. Share an insight, caveat, or question.
Doundoulakis et al. (2024) conducted a systematic review in Brugada Syndrome (n=709). Catheter ablation vs. ICD therapy only was evaluated on Incidence of ventricular arrhythmias during follow-up (OR 0.03, 95% CI 0.01-0.12). Catheter ablation significantly reduced the incidence of ventricular arrhythmias compared to ICD therapy alone in Brugada Syndrome patients (OR 0.03; 95% CI 0.01-0.12).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: