Outcome after implantable cardioverter-defibrillator in patients with Brugada syndrome: the Gulf Brugada syndrome registry

Amin Daoulah, Alawi A Alsheikh-Ali, Ali H Ocheltree, Sara Ocheltree, Salem Al-Kaabi, Majed Malik, Abdul-Karim Al-Habib, Adel Hamed, Najib Al-Rawahi, Ali Al-Sayegh, Saad Al-Hasaniah, Eijaz Ul-Haq
Journal of Electrocardiology 2012, 45 (3): 327-32

BACKGROUND AND OBJECTIVE: Among patients with Brugada syndrome (BS) and aborted cardiac arrest, syncope, or inducible ventricular fibrillation at electrophysiologic study (EPS), the only currently recommended therapy is an implantable cardioverter-defibrillator (ICD), but these are not without complications. We assessed the total number of shocks (appropriate and inappropriate) and complications related to ICD in patients with BS.

METHODS AND RESULTS: Twenty-five patients implanted with ICD for BS in 6 Gulf centers between January 1, 2002, and December 31, 2010, were reviewed. Implantable cardioverter-defibrillator indication was based on aborted cardiac arrest (24%), syncope (56%), or in asymptomatic patients with positive EPS (20%). During a follow-up of 41.2 ± 17.6 months, 3 patients (all with prior cardiac arrest) had appropriate device therapy. Four patients developed complications; 3 of them had inappropriate shocks.

CONCLUSION: In our cohort, appropriate device therapy was limited to cardiac arrest survivors, whereas none of those with syncope and/or positive EPS had arrhythmias. Overall complication rate was relatively high, including inappropriate ICD shocks.

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