Abstract
Background
In Brugada syndrome implantable cardioverter defibrillator (ICD) therapy is associated with a high rate of inappropriate therapies, mainly due to supraventricular tachyarrhythmias (SVT) (2.7–14.1%/year). Aim of the present study was to evaluate a single ventricular fibrillation (VF) detection zone with a high cut-off rate with respect to prevention of inappropriate ICD shock due to SVT and safety of this programming.
Methods
Sixty-one consecutive patients (mean age 42.6 ± 12.9 years; 41 males) diagnosed with Brugada syndrome and implanted with an ICD were included. ICDs were prospectively programmed with a single VF detection zone and a cut-off rate of 222 beats/minute (bpm). A maximum of six shocks with the maximal shock energy were programmed. The minimal follow-up was 1 year.
Results
During a follow-up of 47.6 ± 23.1 months seven patients (2.91%/year) received appropriate ICD shocks. No patient suffered from syncope or died. Five patients (2.07%/year) received inappropriate ICD shocks: four patients due to T-wave oversensing and only one patient (0.4%/year) due to SVT (atrial fibrillation with a ventricular rate of >222 bpm).
Conclusions
Programming of a single, high-rate VF zone in patients with Brugada syndrome and an implanted defibrillator is safe. Such programming may be associated with reduced inappropriate defibrillator discharges. A single detection zone with a high VF cut-off rate can be recommended in patients with Brugada syndrome.
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C. Veltmann and J. Kuschyk contributed equally to the work.
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Veltmann, C., Kuschyk, J., Schimpf, R. et al. Prevention of inappropriate ICD shocks in patients with Brugada syndrome. Clin Res Cardiol 99, 37–44 (2010). https://doi.org/10.1007/s00392-009-0075-4
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DOI: https://doi.org/10.1007/s00392-009-0075-4