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- Title
Usefulness of subcutaneous implantable cardioverter-defibrillator therapy in patients with Brugada syndrome.
- Authors
Shinohara, Tetsuji; Abe, Ichitaro; Hirota, Kei; Kondo, Hidekazu; Fukui, Akira; Akioka, Hidefumi; Teshima, Yasushi; Yufu, Kunio; Nakagawa, Mikiko; Takahashi, Naohiko
- Abstract
Implantable cardioverter-defibrillators (ICDs) are the main therapy to prevent sudden cardiac death in patients with Brugada syndrome (BrS). The subcutaneous ICD (S-ICD) can eliminate lead-associated complications compared with transvenous ICD (TV-ICD). However, S-ICD is susceptible to T-wave oversensing (TWOS) and may result in more frequent inappropriate shocks in patients with BrS. This study aimed to compare inappropriate shocks between TV-ICD and S-ICD in patients with BrS. We enrolled 32 patients with BrS (including one woman; mean age 52 ± 18 years) who were implanted with ICD (23 TV-ICDs and 9 S-ICDs) between January 2002 and November 2018 in Oita University Hospital. We carried out a standard surface electrocardiogram (ECG) screening tests in both supine and standing positions prior to S-ICD implantation. The patients received routine clinical review every month and device monitoring every 4 months. The period of follow-up was 129 ± 51 months. Six patients with BrS and TV-ICDs experienced inappropriate shocks (26%) with their ICD therapy. In contrast, two patients with BrS and S-ICDs experienced inappropriate shocks (22%). There was no significant difference between the two groups (P = 0.82). Although one case in the S-ICD group experienced TWOS-induced inappropriate shock, SMART Pass (new high-pass filter) prevented the subsequent recurrence of inappropriate shocks during ICD therapy. Our results suggest that S-ICD is not inferior to TV-ICD in the incidence of inappropriate shocks. SMART Pass may be a useful tool to prevent inappropriate ICD shocks by TWOS in patients with BrS.
- Subjects
IMPLANTABLE cardioverter-defibrillators; CARDIAC arrest; HIGHPASS electric filters; STANDING position; SUPINE position; CARDIAC patients; BRUGADA syndrome
- Publication
Heart & Vessels, 2021, Vol 36, Issue 2, p260
- ISSN
0910-8327
- Publication type
Article
- DOI
10.1007/s00380-020-01683-0