A MEDIAN FOLLOW-UP OF TWENTY-TWO MONTHS FOR CARDIOVERTER DEFIBRILLATOR IMPLANTATION IN SYMPTOMATIC OR ASYMPTOMATIC PATIENTS WITH BRUGADA SYNDROME

作     者：蔡煦 苏静英 黄剑锋 沈卫峰 Stéphane Garrigue Pierre Bordachar Jacques Cl menty 

作者机构：Department of CardiologyRuijin HospitalSchool of MedicineShanghai Jiaotong University Department of Cardiac Pacing and Clinical ElectrophysiologyHpital Cardiologique du Haut-LévêqueUniversity Bordeaux Ⅱ19 Avenue de Magellan 

出 版 物：《Medical Bulletin of Shanghai Jiaotong University》 (上海交通大学学报（医学英文版）)

年 卷 期：2010年第22卷第1期

页      面：47-53页

学科分类：0831[工学-生物医学工程（可授工学、理学、医学学位）] 1004[医学-公共卫生与预防医学(可授医学、理学学位)] 0905[农学-畜牧学] 08[工学] 09[农学] 090501[农学-动物遗传育种与繁殖] 10[医学] 

主　　题：Brugada syndorme implantable cardioverter defibrillator 

摘      要：Objective To explore the outcome of patients with Brugada syndrome by remedial or prophylactic implantable cardioverter defibrillator （ ICD ） for ventricular tachyarrhythmia. Methods Sixteen single chamber ICDs and 5 double chamber ICDs in 21 consecutive patients [ 17 males, 4 females; mean age, （ 36 ± 11） years ] with Brugada syndrome were involved. Fifteen patients with spontaneous or induced ventricular tachycardia/ventricular fibrillation （VT/VF） received the remedial and prophylactic ICD implantation. Six patients only with positive family history or syncope accepted the ICD implantation for prophylaxis. Results After a median follow-up of （22.3 ± 13. 4） months, all patients were alive. One patient was suspected with febrile syndrome due to endocarditis on the auricular face of the lead of defibrillator 18 months after 1CD implantation and disappearance of vegetation was found after receiving one-month antibiotic treatment. Nine appropriate ICD interventions took place in 3 individuals with documented spontaneous ventricular arrhythmias. Multivariable analysis suggested that occurrence of appropriate interventions was related to the spontaneous ventricular arrhythmias （ P 〈 0. 0001 ）. Eleven inappropriate ICD interventions occurred in 3 patients for atrial fibrillation or atrial flutter with rapid ventricular rate. Multivariable analysis suggested that occurrence of inappropriate interventions was related to documented spontaneous supraventricular arrhythmias （P 〈 O. 0062 ）. All appropriate interventions and inappropriate interventions occurred within six months after ICD implantation. Conclusion Appropriate interventions may associate to spontaneous ventricular arrhythmias before 1CD implantation in patients with Brugada syndrome. Patients may suffer from inappropriate ICD intervention for supraventricular arrhythmias with rapid ventricular rate when they had a history of supraventricular arrhythmias.