Key result
Epicardial ablation shows promise for recurrent ventricular arrhythmias in Brugada syndrome, potentially obviating ICDs.
Why the study?
Recent findings of epicardial fibrosis as an arrhythmogenic substrate in Brugada syndrome have introduced catheter ablation as an emerging therapeutic approach, warranting a review of current evidence.
Does epicardial ablation prevent recurrent ventricular arrhythmias in patients with Brugada syndrome?
Does epicardial ablation prevent recurrent ventricular arrhythmias in patients with Brugada syndrome?
Epicardial ablation of the right ventricular outflow tract offers a promising therapeutic strategy for preventing recurrent ventricular arrhythmias in high-risk patients with Brugada syndrome.
BACKGROUND: Brugada syndrome (BrS) is an inherited arrhythmogenic syndrome characterized by cove-shaped ST-segment elevation in leads V1-V3 and incomplete or complete right bundle branch block. BrS exhibits autosomal dominant inheritance with incomplete penetrance and a male predominance. It carries a significant risk of sudden cardiac death due to ventricular fibrillation (VF). MAIN BODY: Recent studies have highlighted the presence of epicardial fibrosis as a proarrhythmic substrate in BrS, revolutionizing our understanding of the disease's pathophysiology. Catheter ablation has emerged as a crucial intervention for symptomatic BrS patients experiencing recurrent episodes of ventricular tachycardia (VT) or VF. By potentially obviating the need for implantable cardioverter-defibrillator (ICD) implantation, epicardial ablation offers a promising therapeutic approach. CONCLUSION: This review emphasizes the significance of current evidence and ongoing research in shaping the role of epicardial ablation as a curative strategy in BrS management, highlighting its potential benefits and the necessity for further investigation.
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Abuzuagaia et al. (2024) conducted a review in Brugada syndrome. Epicardial ablation was evaluated. Epicardial ablation has emerged as a promising therapeutic approach for symptomatic Brugada syndrome patients experiencing recurrent ventricular arrhythmias, potentially obviating the need for ICDs.
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