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September 9, 2026EP EuropaceOpen Access

Appropriate and inappropriate therapies in patients with Brugada syndrome. What to expect? Authors’ reply

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Population

Single 24-year-old patient with Type 1 BrS and an implanted ICD for secondary prevention of SCD

Design

Letter / case report

Follow-up

More than 1 year

Key result

A 24-year-old patient with Brugada syndrome experienced an inappropriate ICD shock for sinus tachycardia, which was resolved by reprogramming the device.

Authors

MDMaciej DyrbuśMGMariusz GąsiorMTMateusz Tajstra

Discussion

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Overview

Reprogramming may avert inappropriate shocks in active Brugada patients; leaves open optimal VT-zone thresholds for inherited arrhythmia syndromes.

Key Points

  • Address the risk profile of appropriate versus inappropriate implantable cardioverter-defibrillator interventions and evaluate the role of device programming in patients with Brugada syndrome.
  • Analyzed clinical and remote monitoring records of patients with inherited arrhythmia syndromes managed at a single institution.
  • Evaluated follow-up data exceeding 1 year in a 24-year-old male with Type 1 Brugada syndrome who received an ICD for secondary prevention of sudden cardiac death.
  • The patient received an inappropriate anti-tachycardia pacing sequence followed by an inappropriate shock triggered by sinus tachycardia reaching approximately 180 beats per minute within the programmed ventricular tachycardia zone.
  • Liberalization and reprogramming of ventricular tachycardia detection thresholds successfully prevented subsequent inappropriate shocks while accurately discriminating supraventricular tachyarrhythmias.

Structured PICO

P
Population
A single 24-year-old patient with Type 1 Brugada syndrome who had an ICD implanted for secondary prevention of sudden cardiac death.
I
Intervention
Implantable cardioverter-defibrillator (ICD) with remote monitoring and subsequent device reprogramming
O
Outcome
Inappropriate ICD therapy (shock for sinus tachycardia)safety

Appropriate patient selection and device programming are crucial in young, active patients with primarily arrhythmic diseases like Brugada syndrome to prevent inappropriate ICD therapies.

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Cite This Study

Dyrbuś et al. (2023) conducted a letter in Brugada syndrome (n=1). Implantable cardioverter-defibrillator (ICD) was evaluated. A 24-year-old patient with Brugada syndrome experienced an inappropriate ICD shock for sinus tachycardia, which was resolved by reprogramming the device.

synapsesocial.com/papers/6aa0c50d6f34c07c194fb9efhttps://doi.org/10.1093/europace/euad251
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