Usefulness of subcutaneous implantable cardioverter-defibrillator therapy in patients with Brugada syndrome
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:36 |
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| Enthalten in: |
Heart and vessels - 36(2021), 2 vom: 24. Feb., Seite 260-266 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Shinohara, Tetsuji [VerfasserIn] |
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| Links: |
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| Themen: |
Brugada syndrome |
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| Anmerkungen: |
Date Completed 14.07.2021 Date Revised 14.07.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00380-020-01683-0 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM314065784 |
|---|
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| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a Brugada syndrome | |
| 650 | 4 | |a Inappropriate shock | |
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| 650 | 4 | |a Subcutaneous implantable cardioverter-defibrillator | |
| 650 | 4 | |a T-wave oversensing | |
| 700 | 1 | |a Abe, Ichitaro |e verfasserin |4 aut | |
| 700 | 1 | |a Hirota, Kei |e verfasserin |4 aut | |
| 700 | 1 | |a Kondo, Hidekazu |e verfasserin |4 aut | |
| 700 | 1 | |a Fukui, Akira |e verfasserin |4 aut | |
| 700 | 1 | |a Akioka, Hidefumi |e verfasserin |4 aut | |
| 700 | 1 | |a Teshima, Yasushi |e verfasserin |4 aut | |
| 700 | 1 | |a Yufu, Kunio |e verfasserin |4 aut | |
| 700 | 1 | |a Nakagawa, Mikiko |e verfasserin |4 aut | |
| 700 | 1 | |a Takahashi, Naohiko |e verfasserin |4 aut | |
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