TY - JOUR
T1 - Subcutaneous versus transvenous implantable cardioverter-defibrillator among drug-induced type-1 ECG pattern Brugada syndrome
T2 - a propensity score matching analysis from IBRYD study
AU - IBRYD Study Group
AU - Russo, Vincenzo
AU - Caturano, Alfredo
AU - Guerra, Federico
AU - Migliore, Federico
AU - Mascia, Giuseppe
AU - Rossi, Andrea
AU - Nesti, Martina
AU - Santobuono, Vincenzo Ezio
AU - Attena, Emilio
AU - Tola, Gianfranco
AU - Sciarra, Luigi
AU - Conte, Giulio
AU - Paoletti Perini, Alessandro
AU - Francia, Pietro
AU - Dendramis, Gregory
AU - Palamà, Zefferino
AU - Albani, Stefano
AU - Ottonelli Ghidini, Andrea
AU - Calò, Leonardo
AU - D'Onofrio, Antonio
AU - Baldi, Enrico
N1 - Publisher Copyright:
© 2022, The Author(s).
Copyright:
Copyright 2022 Elsevier B.V., All rights reserved.
PY - 2023/5
Y1 - 2023/5
N2 - No real-world data are available about the complications rate in drug-induced type 1 Brugada Syndrome (BrS) patients with an implantable cardioverter-defibrillator (ICD). Aim of our study is to compare the device-related complications, infections, and inappropriate therapies among drug-induced type 1 BrS patients with transvenous- ICD (TV-ICD) versus subcutaneous-ICD (S-ICD). Data for this study were sourced from the IBRYD (Italian BRugada sYnDrome) registry which includes 619 drug-induced type-1 BrS patients followed at 20 Italian tertiary referral hospitals. For the present analysis, we selected 258 consecutive BrS patients implanted with ICD. 198 patients (76.7%) received a TV-ICD, while 60 a S-ICD (23.4%). And were followed-up for a median time of 84.3 [46.5-147] months. ICD inappropriate therapies were experienced by 16 patients (6.2%). 14 patients (7.1%) in the TVICD group and 2 patients (3.3%) in S-ICD group (log-rank P = 0.64). ICD-related complications occurred in 31 patients (12%); 29 (14.6%) in TV-ICD group and 2 (3.3%) in S-ICD group (log-rank P = 0.41). ICD-related infections occurred in 10 patients (3.88%); 9 (4.5%) in TV-ICD group and 1 (1.8%) in S-ICD group (log-rank P = 0.80). After balancing for potential confounders using the propensity score matching technique, no differences were found in terms of clinical outcomes between the two groups. In a real-world setting of drug-induced type-1 BrS patients with ICD, no significant differences in inappropriate ICD therapies, device-related complications, and infections were shown among S-ICD vs TV-ICD. However, a reduction in lead-related complications was observed in the S-ICD group. In conclusion, our evidence suggests that S-ICD is at least non-inferior to TV-ICD in this population and may also reduce the risk of lead-related complications which can expose the patients to the necessity of lead extractions.
AB - No real-world data are available about the complications rate in drug-induced type 1 Brugada Syndrome (BrS) patients with an implantable cardioverter-defibrillator (ICD). Aim of our study is to compare the device-related complications, infections, and inappropriate therapies among drug-induced type 1 BrS patients with transvenous- ICD (TV-ICD) versus subcutaneous-ICD (S-ICD). Data for this study were sourced from the IBRYD (Italian BRugada sYnDrome) registry which includes 619 drug-induced type-1 BrS patients followed at 20 Italian tertiary referral hospitals. For the present analysis, we selected 258 consecutive BrS patients implanted with ICD. 198 patients (76.7%) received a TV-ICD, while 60 a S-ICD (23.4%). And were followed-up for a median time of 84.3 [46.5-147] months. ICD inappropriate therapies were experienced by 16 patients (6.2%). 14 patients (7.1%) in the TVICD group and 2 patients (3.3%) in S-ICD group (log-rank P = 0.64). ICD-related complications occurred in 31 patients (12%); 29 (14.6%) in TV-ICD group and 2 (3.3%) in S-ICD group (log-rank P = 0.41). ICD-related infections occurred in 10 patients (3.88%); 9 (4.5%) in TV-ICD group and 1 (1.8%) in S-ICD group (log-rank P = 0.80). After balancing for potential confounders using the propensity score matching technique, no differences were found in terms of clinical outcomes between the two groups. In a real-world setting of drug-induced type-1 BrS patients with ICD, no significant differences in inappropriate ICD therapies, device-related complications, and infections were shown among S-ICD vs TV-ICD. However, a reduction in lead-related complications was observed in the S-ICD group. In conclusion, our evidence suggests that S-ICD is at least non-inferior to TV-ICD in this population and may also reduce the risk of lead-related complications which can expose the patients to the necessity of lead extractions.
KW - Brugada syndrome
KW - Drug-induced type 1 Brugada syndrome
KW - ICD-related complication
KW - ICD-related infection
KW - Implantable cardioverter-defibrillator
KW - Inappropriate shock
KW - Subcutaneous cardioverter-defibrillator
KW - Sudden cardiac death
KW - Transvenous cardioverter-defibrillator
UR - http://www.scopus.com/inward/record.url?scp=85142662829&partnerID=8YFLogxK
U2 - 10.1007/s00380-022-02204-x
DO - 10.1007/s00380-022-02204-x
M3 - Article
C2 - 36418560
VL - 38
SP - 680
EP - 688
JO - Heart and Vessels
JF - Heart and Vessels
SN - 0910-8327
IS - 5
ER -