Key result
Catheter ablation, particularly targeting the epicardial substrate in the right ventricular outflow tract, has emerged as an effective therapy for preventing recurrent ventricular fibrillation in patients with Brugada syndrome.
Why the study?
ICDs do not prevent VF in Brugada syndrome and antiarrhythmic drugs carry notable adverse effects, highlighting the evolving role and progress of catheter ablation.
Epicardial catheter ablation is an increasingly applicable and effective alternative therapy for managing recurrent ventricular fibrillation in Brugada syndrome.
Brugada syndrome (BrS) is an arrhythmogenic disease associated with an increased risk of ventricular fibrillation (VF) and sudden cardiac death (SCD). To date, the standard therapy for the prevention of SCD in BrS is the use of an implantable cardioverter-defibrillator (ICD) especially in patients who have experienced a prior cardiac arrest or syncopal events secondary to VF. However, ICDs do not prevent the occurrence of VF but react to defibrillate the VF episode, thereby preventing SCD. Often patients with recurrent VF have to be maintained on antiarrhythmic drugs that are effective but have remarkable adverse effects. An alternative therapy for BrS with recurrent VF is catheter ablation which emerged as an effective therapy in eliminating VF-triggering premature ventricular complexes in limited case series; however, there has been a remarkable progress in effectiveness of catheter ablation since epicardial substrate ablation was first applied in 2011 and such approach is now widely applicable.
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Talib et al. (2019) conducted a review in Brugada syndrome. Catheter ablation was evaluated. Catheter ablation, particularly targeting the epicardial substrate in the right ventricular outflow tract, has emerged as an effective therapy for preventing recurrent ventricular fibrillation in patients with Brugada syndrome.
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