Catheter ablation as an adjunctive therapy to ICD implantation in Brugada syndrome.

IF 4.8 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

European Heart Journal - Quality of Care and Clinical Outcomes Pub Date : 2024-05-22 DOI:10.1093/ehjqcco/qcae040

Ioannis Doundoulakis, Sotirios Chiotis, Luigi Pannone, Domenico Giovanni Della Rocca, Antonio Sorgente, Athanasios Kordalis, Roberto Scacciavillania, Stefanos Zafeiropoulos, Lorenzo Marcon, Giampaolo Vetta, Eirini Pagkalidou, Gezim Bala, Alexandre Almorad, Erwin Ströker, Juan Sieira, Mark La Meir, Pedro Brugada, Dimitrios Tsiachris, Andrea Sarkozy, Gian Battista Chierchia, Carlo de Asmundis

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引用次数: 0

Abstract

Background: Brugada Syndrome (BrS) is a life-threatening cardiac arrhythmia disorder associated with an increased risk ventricular arrhythmias (VAs) and sudden cardiac death (SCD). Current management primarily relies on implantable cardioverter-defibrillators (ICDs), but patients may experience ICD shocks. Catheter ablation (CA) has emerged as a potential intervention to target the arrhythmogenic substrate. This systematic review aims to evaluate the safety and efficacy of catheter ablation in BrS patients.

Methods and results: Studies with BrS patients undergoing catheter ablation for VAs were included. 14 studies that involved a total population of 709 BrS patients, with catheter ablation performed in 528 of them, were included. Catheter ablation resulted in non-inducibility of VAs in 91% (95% CI: 83-99, I2 = 76%) and resolution of Type 1 ECG Brugada pattern in 88% (95% CI: 81-96.2, I2 = 91%) of the patients. After a mean follow-up of 30.7 months, 87% (95% CI: 80-94, I2 = 82%) of patients remained free from VAs. The incidence of VAs during follow-up was significantly lower in the ablation cohort in comparison to the group receiving only ICD therapy (OR = 0.03, 95% CI: 0.01-0.12, I2 = 0%).

Conclusion: Catheter ablation shows potential as a therapeutic approach to reduce VAs and improve outcomes in BrS patients. While further research with long follow-up period is required to confirm these findings, it represents a valuable tool as an add-on intervention to ICD implantation in BrS patients with high burden of VAs.Protocol registration: CRD42024506439.

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导管消融作为 Brugada 综合征 ICD 植入术的辅助疗法。

背景：布鲁加达综合征（BrS）是一种危及生命的心律失常疾病，与室性心律失常（VAs）和心脏性猝死（SCD）风险增加有关。目前的治疗主要依靠植入式心律转复除颤器（ICD），但患者可能会受到 ICD 电击。导管消融术（CA）已成为一种针对致心律失常基质的潜在干预方法。本系统综述旨在评估导管消融术对 BrS 患者的安全性和有效性：方法和结果：纳入了对因VAs而接受导管消融术的BRS患者的研究。14项研究共涉及709名BRS患者，其中528人接受了导管消融术。91%（95% CI：83-99，I2 = 76%）的患者接受导管消融术后不再诱发VAs，88%（95% CI：81-96.2，I2 = 91%）的患者心电图1型Brugada模式消失。平均随访 30.7 个月后，87%（95% CI：80-94，I2 = 82%）的患者仍未出现 VAs。与仅接受 ICD 治疗的组别相比，消融组在随访期间的 VAs 发生率明显降低（OR = 0.03，95% CI：0.01-0.12，I2 = 0%）：结论：导管消融作为一种治疗方法，具有减少 VAs 和改善 BrS 患者预后的潜力。结论：导管消融术作为一种治疗方法，具有减少BRS患者VA并改善其预后的潜力，虽然还需要进一步的长期随访研究来证实这些发现，但它是一种有价值的工具，可作为ICD植入术的附加干预措施，用于治疗VA负担较重的BRS患者：CRD42024506439。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Heart Journal - Quality of Care and Clinical Outcomes CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

9.40

自引率

3.80%

发文量

期刊介绍： European Heart Journal - Quality of Care & Clinical Outcomes is an English language, peer-reviewed journal dedicated to publishing cardiovascular outcomes research. It serves as an official journal of the European Society of Cardiology and maintains a close alliance with the European Heart Health Institute. The journal disseminates original research and topical reviews contributed by health scientists globally, with a focus on the quality of care and its impact on cardiovascular outcomes at the hospital, national, and international levels. It provides a platform for presenting the most outstanding cardiovascular outcomes research to influence cardiovascular public health policy on a global scale. Additionally, the journal aims to motivate young investigators and foster the growth of the outcomes research community.