Long-term outcome of pulmonary vein isolation in patients with paroxysmal atrial fibrillation and Brugada syndrome

Giacomo Mugnai, Burak Hünük, Erwin Ströker, Diego Ruggiero, Hugo Enrique Coutino-Moreno, Ken Takarada, Valentina De Regibus, Rajin Choudhury, Juan Pablo Abugattas de Torres, Darragh Moran, Saverio Iacopino, Pasquale Filannino, Giulio Conte, Juan Sieira, Jan Poelaert, Stefan Beckers, Pedro Brugada, Carlo de Asmundis, Gian-Battista Chierchia

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

Aims: The therapeutical management of atrial fibrillation (AF) in the setting of Brugada syndrome (BS) might be challenging as many antiarrhythmic drugs (AADs) with sodium channel blocking properties might lead to to the development of ventricular arrhythmias. This study sought to evaluate the clinical outcome in a consecutive series of patients with BS having undergone pulmonary vein (PV) isolation by means of radiofrequency (RF) or cryoballoon (CB) ablation and the efficacy of catheter ablation for preventing inappropriate interventions delivered by implantable cardioverter defibrillators (ICD) on a 3-year follow up.

Methods and results: Twenty-three consecutive patients with BS (13 males; mean age was 47 ± 18 years) having undergone PV isolation for drug-resistant paroxysmal AF were enrolled. Eleven patients (48%) had an ICD implanted of whom four had inappropriate shocks secondary to rapid AF. Over a mean follow-up period of 35.0 ± 25.4 months (median 36 months) the freedom from AF recurrence after the index PV isolation procedure was 74% without AADs. Patients with inappropriate ICD interventions for AF did not present futher ICD shocks after AF ablation. No major complications occurred.

Conclusion: Catheter ablation is a valid therapeutic choice for patients with BS and paroxysmal AF considering the high success rates, the limitations of the AADs and the safety of the procedure, and it should be taken into consideration especially in those patients presenting inappropriate ICD shocks due to rapid AF.

Original languageEnglish
Pages (from-to)548–554
Number of pages7
JournalEuropace
Volume20
Issue number3
Early online date2017
DOIs
Publication statusPublished - 9 Mar 2017

Bibliographical note

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

Keywords

  • Action Potentials
  • Adult
  • Aged
  • Atrial Fibrillation/complications
  • Brugada Syndrome/complications
  • Catheter Ablation/adverse effects
  • Cryosurgery/adverse effects
  • Defibrillators, Implantable
  • Electric Countershock/instrumentation
  • Female
  • Heart Rate
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Veins/physiopathology
  • Registries
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome

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