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

Carlo de Asmundis; 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

doi:10.1093/ehjqcco/qcae040

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

Carlo de Asmundis, 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 SarkozyGian Battista Chierchia

Onderzoeksoutput: Other contribution

Samenvatting

Background
Brugada Syndrome (BrS) is a life-threatening cardiac arrhythmia disorder associated with an increased risk of ventricular arrhythmias (VAs) and sudden cardiac death. 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 CA in BrS patients.

Methods and results
Studies with BrS patients undergoing CA for VAs were included. Fourteen studies that involved a total population of 709 BrS patients, with CA performed in 528 of them, were included. CA resulted in the 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
CA shows potential as a therapeutic approach to reduce VAs and improve outcomes in BrS patients. While further research with a 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 a high burden of VAs.

Originele taal-2	English
Mijlpalentype toekennen	original research
Outputmedia	text
DOI's	https://doi.org/10.1093/ehjqcco/qcae040
Status	Published - 21 mei 2024

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10.1093/ehjqcco/qcae040

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https://doi.org/10.1093/ehjqcco/qcae040

Citeer dit

Asmundis, C. D., Doundoulakis, I., Chiotis, S., Pannone, L., Rocca, D. G. D., Sorgente, A., Kordalis, A., Scacciavillania, R., Zafeiropoulos, S., Marcon, L., Vetta, G., Pagkalidou, E., Bala, G., Almorad, A., Ströker, E., Sieira, J., Meir, M. L., Brugada, P., Tsiachris, D., ... Chierchia, G. B. (2024, mei 21). Catheter ablation as an adjunctive therapy to ICD implantation in Brugada syndrome. https://doi.org/10.1093/ehjqcco/qcae040

Asmundis, Carlo de ; Doundoulakis, Ioannis ; Chiotis, Sotirios ; Pannone, Luigi ; Rocca, Domenico Giovanni Della ; Sorgente, Antonio ; Kordalis, Athanasios ; Scacciavillania, Roberto ; Zafeiropoulos, Stefanos ; Marcon, Lorenzo ; Vetta, Giampaolo ; Pagkalidou, Eirini ; Bala, Gezim ; Almorad, Alexandre ; Ströker, Erwin ; Sieira, Juan ; Meir, Mark La ; Brugada, Pedro ; Tsiachris, Dimitrios ; Sarkozy, Andrea ; Chierchia, Gian Battista. / Catheter ablation as an adjunctive therapy to ICD implantation in Brugada syndrome. 2024.

@misc{7ddb87da6d4643e09f06e923fb0cab25,

title = "Catheter ablation as an adjunctive therapy to ICD implantation in Brugada syndrome",

abstract = "BackgroundBrugada Syndrome (BrS) is a life-threatening cardiac arrhythmia disorder associated with an increased risk of ventricular arrhythmias (VAs) and sudden cardiac death. 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 CA in BrS patients.Methods and resultsStudies with BrS patients undergoing CA for VAs were included. Fourteen studies that involved a total population of 709 BrS patients, with CA performed in 528 of them, were included. CA resulted in the 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%).ConclusionCA shows potential as a therapeutic approach to reduce VAs and improve outcomes in BrS patients. While further research with a 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 a high burden of VAs.",

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

year = "2024",

month = may,

day = "21",

doi = "10.1093/ehjqcco/qcae040",

language = "English",

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}

Asmundis, CD , Doundoulakis, I, Chiotis, S, Pannone, L, Rocca, DGD, Sorgente, A, Kordalis, A, Scacciavillania, R, Zafeiropoulos, S, Marcon, L , Vetta, G, Pagkalidou, E, Bala, G , Almorad, A , Ströker, E, Sieira, J, Meir, ML , Brugada, P, Tsiachris, D, Sarkozy, A & Chierchia, GB 2024, Catheter ablation as an adjunctive therapy to ICD implantation in Brugada syndrome.. https://doi.org/10.1093/ehjqcco/qcae040

Catheter ablation as an adjunctive therapy to ICD implantation in Brugada syndrome. / Asmundis, Carlo de ; Doundoulakis, Ioannis; Chiotis, Sotirios; Pannone, Luigi; Rocca, Domenico Giovanni Della; Sorgente, Antonio; Kordalis, Athanasios; Scacciavillania, Roberto; Zafeiropoulos, Stefanos; Marcon, Lorenzo ; Vetta, Giampaolo; Pagkalidou, Eirini; Bala, Gezim ; Almorad, Alexandre ; Ströker, Erwin; Sieira, Juan; Meir, Mark La ; Brugada, Pedro; Tsiachris, Dimitrios; Sarkozy, Andrea ; Chierchia, Gian Battista.

2024, original research.

Onderzoeksoutput: Other contribution

TY - GEN

T1 - Catheter ablation as an adjunctive therapy to ICD implantation in Brugada syndrome

AU - Asmundis, Carlo de

AU - Doundoulakis, Ioannis

AU - Chiotis, Sotirios

AU - Pannone, Luigi

AU - Rocca, Domenico Giovanni Della

AU - Sorgente, Antonio

AU - Kordalis, Athanasios

AU - Scacciavillania, Roberto

AU - Zafeiropoulos, Stefanos

AU - Marcon, Lorenzo

AU - Vetta, Giampaolo

AU - Pagkalidou, Eirini

AU - Bala, Gezim

AU - Almorad, Alexandre

AU - Ströker, Erwin

AU - Sieira, Juan

AU - Meir, Mark La

AU - Brugada, Pedro

AU - Tsiachris, Dimitrios

AU - Sarkozy, Andrea

AU - Chierchia, Gian Battista

PY - 2024/5/21

Y1 - 2024/5/21

N2 - BackgroundBrugada Syndrome (BrS) is a life-threatening cardiac arrhythmia disorder associated with an increased risk of ventricular arrhythmias (VAs) and sudden cardiac death. 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 CA in BrS patients.Methods and resultsStudies with BrS patients undergoing CA for VAs were included. Fourteen studies that involved a total population of 709 BrS patients, with CA performed in 528 of them, were included. CA resulted in the 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%).ConclusionCA shows potential as a therapeutic approach to reduce VAs and improve outcomes in BrS patients. While further research with a 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 a high burden of VAs.

AB - BackgroundBrugada Syndrome (BrS) is a life-threatening cardiac arrhythmia disorder associated with an increased risk of ventricular arrhythmias (VAs) and sudden cardiac death. 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 CA in BrS patients.Methods and resultsStudies with BrS patients undergoing CA for VAs were included. Fourteen studies that involved a total population of 709 BrS patients, with CA performed in 528 of them, were included. CA resulted in the 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%).ConclusionCA shows potential as a therapeutic approach to reduce VAs and improve outcomes in BrS patients. While further research with a 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 a high burden of VAs.

UR - https://doi.org/10.1093/ehjqcco/qcae040

U2 - 10.1093/ehjqcco/qcae040

DO - 10.1093/ehjqcco/qcae040

M3 - Other contribution

ER -